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J Int Med Res
. 2020 Oct;48(10):300060520966151.
doi: 10.1177/0300060520966151.
Fibrinolysis is a reasonable alternative for STEMI care during the COVID-19 pandemic
Nan Wang 1 , Min Zhang 2 3 , Huajun Su 4 , Zhonglue Huang 4 , Yongbo Lin 5 , Min Zhang 2 3
Affiliations
- PMID: 33108941
- DOI: 10.1177/0300060520966151
Abstract
Objective: No data are available to develop uniform recommendations for reperfusion therapies in ST-segment elevation myocardial infarction (STEMI) during the coronavirus disease 2019 (COVID-19) pandemic. We aimed to fill the evidence gap regarding STEMI reperfusion strategy during the COVID-19 era.
Methods: Clinical characteristics and outcomes for 17 patients with STEMI who received fibrinolysis during the COVID-19 pandemic were compared with 20 patients who received primary percutaneous coronary intervention (PPCI), and were further compared with another 41 patients who received PPCI in the pre-COVID-19 period.
Results: In patients with STEMI, fibrinolysis achieved a comparable in-hospital and 30-day primary composite end point, as compared with those who received PPCI during the COVID-19 pandemic. No major bleeding was detected in either group. Compared patients with STEMI who received PPCI in the pre-COVID-19 period, we found a remarkable extension of chest pain onset-to-first medical contact (FMC) and FMC-to-wire crossing times, significantly increased number and length of stents, and much worse thrombolysis in myocardial infarction flow in patients with STEMI who received PPCI during the COVID-19 pandemic.
Conclusion: Owing to its considerable efficacy and safety and advantages in conserving medical resources, we recommend fibrinolysis as a reasonable alternative for STEMI care during the COVID-19 pandemic.
Keywords: Coronavirus disease 2019; ST-segment elevation myocardial infarction; efficacy; fibrinolysis; primary percutaneous coronary intervention; safety.