Announcement

Collapse
No announcement yet.

Catheter Cardiovasc Interv Impact of COVID-19 Pandemic on ST-elevation Myocardial Infarction in a non-COVID-19 Epicenter

Collapse
X
 
  • Filter
  • Time
  • Show
Clear All
new posts

  • Catheter Cardiovasc Interv Impact of COVID-19 Pandemic on ST-elevation Myocardial Infarction in a non-COVID-19 Epicenter


    Catheter Cardiovasc Interv


    . 2020 Jun 1.
    doi: 10.1002/ccd.28997. Online ahead of print.
    Impact of COVID-19 Pandemic on ST-elevation Myocardial Infarction in a non-COVID-19 Epicenter


    Tarek A Hammad 1 , Melanie Parikh 1 , Nour Tashtish 1 , Cynthia M Lowry 1 , Diane Gorbey 1 , Farshad Forouzandeh 1 , Steven J Filby 1 , William M Wolf 1 , Marco A Costa 1 , Daniel I Simon 1 , Mehdi H Shishehbor 1



    Affiliations

    Abstract

    Objectives: We sought to study the impact of COVID-19 pandemic on the presentation delay, severity, patterns of care, and reasons for delay among patients with ST-elevation myocardial infarction (STEMI) in a non-hot-spot region.
    Background: COVID-19 pandemic has significantly reduced the activations for STEMI in epicenters like Spain.
    Methods: From January 1, 2020, to April 15, 2020, 143 STEMIs were identified across our integrated 18-hospital system. Pre- and post-COVID-19 cohorts were based on March 23rd, 2020, whenstay-at-home orders were initiated in Ohio. We used presenting heart rate, blood pressure, troponin, new Q-wave, and left ventricle ejection fraction (LVEF) to assess severity. Duration of intensive care unit stay, total length of stay, door-to-balloon (D2B) time, and radial versus femoral access were used to assess patterns of care.
    Results: Post-COVID-19 presentation was associated with a lower admission LVEF (45 vs. 50%, p = .015), new Q-wave, and higher initial troponin; however, these did not reach statistical significance. Among post-COVID-19 patients, those with >12-hr delay in presentation 31(%) had a longer average D2B time (88 vs. 53 min, p = .033) and higher peak troponin (58 vs. 8.5 ng/ml, p = .03). Of these, 27% avoided the hospital due to fear of COVID-19, 18% believed symptoms were COVID-19 related, and 9% did not want to burden the hospital during the pandemic.
    Conclusions: COVID-19 has remarkably affected STEMI presentation and care. Patients' fear and confusion about symptoms are integral parts of this emerging public health crisis.

    Keywords: coronavirus; delayed presentation; door-to-balloon; length of stay; troponin.

Working...
X