Please use this identifier to cite or link to this item:http://hdl.handle.net/20.500.12105/12566
Impact of COVID-19 on ST-segment elevation myocardial infarction care. The Spanish experience
Rodríguez-Leor, Oriol | Cid-Álvarez, Belén | Pérez de Prado, Armando | Rossello, Xavier CNIC | Ojeda, Soledad | Serrador, Ana | López-Palop, Ramón | Martín-Moreiras, Javier | Rumoroso, José Ramón | Cequier, Ángel | Ibanez, Borja CNIC | Cruz-González, Ignacio | Romaguera, Rafael | Moreno, Raúl | Villa, Manuel | Ruíz-Salmerón, Rafael | Molano, Francisco | Sánchez, Carlos | Muñoz-García, Erika | Íñigo, Luís | Herrador, Juan | Gómez-Menchero, Antonio | Caballero, Juan | Cárdenas, Mérida | Gheorghe, Livia | Oneto, Jesús | Morales, Francisco | Valencia, Félix | Ruíz, José Ramón | Diarte, José Antonio | Avanzas, Pablo | Rondán, Juan | Peral, Vicente | Pernasetti, Lucía Vera | Hernández, Julio | Bosa, Francisco | Lorenzo, Pedro Luís Martín | Jiménez, Francisco | Hernández, José M de la Torre | Jiménez-Mazuecos, Jesús | Lozano, Fernando | Moreu, José | Novo, Enrique | Robles, Javier | Moreiras, Javier Martín | Fernández-Vázquez, Felipe | Amat-Santos, Ignacio J | Gómez-Hospital, Joan Antoni | García-Picart, Joan | Blanco, Bruno García Del | Regueiro, Ander | Carrillo-Suárez, Xavier | Tizón, Helena | Mohandes, Mohsen | Casanova, Juan | Agudelo-Montañez, Víctor | Muñoz, Juan Francisco | Franco, Juan | Del Castillo, Roberto | Salinas, Pablo | Elizaga, Jaime | Sarnago, Fernando | Jiménez-Valero, Santiago | Rivero, Fernando | Oteo, Juan Francisco | Alegría-Barrero, Eduardo | Sánchez-Recalde, Ángel | Ruíz, Valeriano | Pinar, Eduardo | Planas, Ana | Ledesma, Bernabé López | Berenguer, Alberto | Fernández-Cisnal, Agustín | Aguar, Pablo | Pomar, Francisco | Jerez, Miguel | Torres, Francisco | García, Ricardo | Frutos, Araceli | Nodar, Juan Miguel Ruíz | García, Koldobika | Sáez, Roberto | Torres, Alfonso | Tellería, Miren | Sadaba, Mario | Mínguez, José Ramón López | Merchán, Juan Carlos Rama | Portales, Javier | Trillo, Ramiro | Aldama, Guillermo | Fernández, Saleta | Santás, Melisa | Pérez, María Pilar Portero
Rev Esp Cardiol. 2020; 73(12):994-1002
The COVID-19 outbreak has had an unclear impact on the treatment and outcomes of patients with ST-segment elevation myocardial infarction (STEMI). The aim of this study was to assess changes in STEMI management during the COVID-19 outbreak. Using a multicenter, nationwide, retrospective, observational registry of consecutive patients who were managed in 75 specific STEMI care centers in Spain, we compared patient and procedural characteristics and in-hospital outcomes in 2 different cohorts with 30-day follow-up according to whether the patients had been treated before or after COVID-19. Suspected STEMI patients treated in STEMI networks decreased by 27.6% and patients with confirmed STEMI fell from 1305 to 1009 (22.7%). There were no differences in reperfusion strategy (> 94% treated with primary percutaneous coronary intervention in both cohorts). Patients treated with primary percutaneous coronary intervention during the COVID-19 outbreak had a longer ischemic time (233 [150-375] vs 200 [140-332] minutes, P < .001) but showed no differences in the time from first medical contact to reperfusion. In-hospital mortality was higher during COVID-19 (7.5% vs 5.1%; unadjusted OR, 1.50; 95%CI, 1.07-2.11; P < .001); this association remained after adjustment for confounders (risk-adjusted OR, 1.88; 95%CI, 1.12-3.14; P = .017). In the 2020 cohort, there was a 6.3% incidence of confirmed SARS-CoV-2 infection during hospitalization. The number of STEMI patients treated during the current COVID-19 outbreak fell vs the previous year and there was an increase in the median time from symptom onset to reperfusion and a significant 2-fold increase in the rate of in-hospital mortality. No changes in reperfusion strategy were detected, with primary percutaneous coronary intervention performed for the vast majority of patients. The co-existence of STEMI and SARS-CoV-2 infection was relatively infrequent.
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