tetano
Editor, Senior Moderator
Neth Heart J
. 2022 Jan 19.
doi: 10.1007/s12471-021-01653-9. Online ahead of print.
COVID-19-mediated patient delay caused increased total ischaemic time in ST-segment elevation myocardial infarction
H N Sturkenboom[SUP] 1 2 [/SUP], V A E van Hattem[SUP] 3 [/SUP], W Nieuwland[SUP] 4 [/SUP], F M A Paris[SUP] 5 [/SUP], M Magro[SUP] 6 [/SUP], R L Anthonio[SUP] 5 [/SUP], A Algin[SUP] 6 [/SUP], E Lipsic[SUP] 4 [/SUP], E Bruwiere[SUP] 7 [/SUP], B J L Van den Branden[SUP] 7 [/SUP], J Polad[SUP] 8 [/SUP], P Tonino[SUP] 3 [/SUP], R A Tio[SUP] 3 9 [/SUP]
Affiliations
Abstract
Background: The current study aimed to evaluate changes in treatment delay and outcome for ST-segment elevation myocardial infarction (STEMI) in the Netherlands during the first coronavirus disease 2019 (COVID-19) outbreak, thereby comparing regions with a high and low COVID-19 hospitalisation rate.
Methods: Clinical characteristics, STEMI timing variables, 30-day all-cause mortality and cardiovascular complications of all consecutive patients admitted for STEMI from 1 January to 30 June in 2020 and 2019 to six hospitals performing a high volume of percutaneous coronary interventions were collected retrospectively using data from the Netherlands Heart Registry, hospital records and ambulance report forms. Patient delay, pre-hospital delay and door-to-balloon time before and after the outbreak of COVID-19 were compared to the equivalent periods in 2019.
Results: A total of 2169 patients were included. During the outbreak median total treatment delay significantly increased (2 h 51 min vs 2 h 32 min; p = 0.043) due to an increased patient delay (1 h 20 min vs 1 h; p = 0.030) with more late presentations > 24 h (1.1% vs 0.3%) in 2020. This increase was particularly evident during the peak phase of COVID-19 in regions with a high COVID-19 hospitalisation rate. During the peak phase door-to-balloon time was shorter (38 min vs 43 min; p = 0.042) than in 2019. All-cause 30-day mortality was comparable in both time frames (7.8% vs 7.3%; p = 0.797).
Conclusions: During the outbreak of COVID-19 patient delay caused an increase in total ischaemic time for STEMI, with a more pronounced delay in high-endemic regions, stressing the importance of good patient education during comparable crisis situations.
Keywords: COVID-19; Door-to-balloon time; Percutaneous coronary intervention; ST-segment myocardial infarction; Treatment delay.
. 2022 Jan 19.
doi: 10.1007/s12471-021-01653-9. Online ahead of print.
COVID-19-mediated patient delay caused increased total ischaemic time in ST-segment elevation myocardial infarction
H N Sturkenboom[SUP] 1 2 [/SUP], V A E van Hattem[SUP] 3 [/SUP], W Nieuwland[SUP] 4 [/SUP], F M A Paris[SUP] 5 [/SUP], M Magro[SUP] 6 [/SUP], R L Anthonio[SUP] 5 [/SUP], A Algin[SUP] 6 [/SUP], E Lipsic[SUP] 4 [/SUP], E Bruwiere[SUP] 7 [/SUP], B J L Van den Branden[SUP] 7 [/SUP], J Polad[SUP] 8 [/SUP], P Tonino[SUP] 3 [/SUP], R A Tio[SUP] 3 9 [/SUP]
Affiliations
- PMID: 35044627
- DOI: 10.1007/s12471-021-01653-9
Abstract
Background: The current study aimed to evaluate changes in treatment delay and outcome for ST-segment elevation myocardial infarction (STEMI) in the Netherlands during the first coronavirus disease 2019 (COVID-19) outbreak, thereby comparing regions with a high and low COVID-19 hospitalisation rate.
Methods: Clinical characteristics, STEMI timing variables, 30-day all-cause mortality and cardiovascular complications of all consecutive patients admitted for STEMI from 1 January to 30 June in 2020 and 2019 to six hospitals performing a high volume of percutaneous coronary interventions were collected retrospectively using data from the Netherlands Heart Registry, hospital records and ambulance report forms. Patient delay, pre-hospital delay and door-to-balloon time before and after the outbreak of COVID-19 were compared to the equivalent periods in 2019.
Results: A total of 2169 patients were included. During the outbreak median total treatment delay significantly increased (2 h 51 min vs 2 h 32 min; p = 0.043) due to an increased patient delay (1 h 20 min vs 1 h; p = 0.030) with more late presentations > 24 h (1.1% vs 0.3%) in 2020. This increase was particularly evident during the peak phase of COVID-19 in regions with a high COVID-19 hospitalisation rate. During the peak phase door-to-balloon time was shorter (38 min vs 43 min; p = 0.042) than in 2019. All-cause 30-day mortality was comparable in both time frames (7.8% vs 7.3%; p = 0.797).
Conclusions: During the outbreak of COVID-19 patient delay caused an increase in total ischaemic time for STEMI, with a more pronounced delay in high-endemic regions, stressing the importance of good patient education during comparable crisis situations.
Keywords: COVID-19; Door-to-balloon time; Percutaneous coronary intervention; ST-segment myocardial infarction; Treatment delay.