Rodríguez-Leor, OriolCid-Álvarez, BelénPérez de Prado, ArmandoRossello, XavierOjeda, SoledadSerrador, AnaLópez-Palop, RamónMartín-Moreiras, JavierRumoroso, José RamónCequier, ÁngelIbáñez, BorjaCruz-González, IgnacioRomaguera, RafaelMoreno, RaúlVilla, ManuelRuíz-Salmerón, RafaelMolano, FranciscoSánchez, CarlosMuñoz-García, ErikaÍñigo, LuísHerrador, JuanGómez-Menchero, AntonioCaballero, JuanCárdenas, MéridaGheorghe, LiviaOneto, JesúsMorales, FranciscoValencia, FélixRuíz, José RamónDiarte, José AntonioAvanzas, PabloRondán, JuanPeral, VicentePernasetti, Lucía VeraHernández, JulioBosa, FranciscoMartín Lorenzo, Pedro LuísJiménez, Franciscode la Torre Hernández, José MJiménez-Mazuecos, JesúsLozano, FernandoMoreu, JoséNovo, EnriqueRobles, JavierMartín Moreiras, JavierFernández-Vázquez, FelipeAmat-Santos, Ignacio JGómez-Hospital, Joan AntoniGarcía-Picart, JoanGarcía del Blanco, BrunoRegueiro, AnderCarrillo-Suárez, XavierTizón, HelenaMohandes, MohsenCasanova, JuanAgudelo-Montañez, VíctorMuñoz, Juan FranciscoFranco, JuanDel Castillo, RobertoSalinas, PabloElizaga, JaimeSarnago, FernandoJiménez-Valero, SantiagoRivero, FernandoOteo, Juan FranciscoAlegría-Barrero, EduardoSánchez-Recalde, ÁngelRuíz, ValerianoPinar, EduardoPlanas, AnaLópez Ledesma, BernabéBerenguer, AlbertoFernández-Cisnal, AgustínAguar, PabloPomar, FranciscoJerez, MiguelTorres, FranciscoGarcía, RicardoFrutos, AraceliRuíz Nodar, Juan MiguelGarcía, KoldobikaSáez, RobertoTorres, AlfonsoTellería, MirenSadaba, MarioLópez Mínguez, José RamónRama Merchán, Juan CarlosPortales, JavierTrillo, RamiroAldama, GuillermoFernández, SaletaSantás, MelisaPortero Pérez, María Pilar2021-04-092021-04-092020-12-01Rev Esp Cardiol. 2020; 73(12):994-10020300-8932http://hdl.handle.net/20.500.12105/12566The 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.spaAM330714277312994-100210.1016/j.recesp.2020.07.0331579-2242Revista espanola de cardiologiaopen access