Portal de Periódicos da CAPES

Impacto de la COVID-19 en el tratamiento del infarto agudo de miocardio con elevación del segmento ST. La experiencia española

2020; Elsevier BV; Volume: 73; Issue: 12 Linguagem: Inglês

10.1016/j.recesp.2020.07.033

1579-2242

Oriol Rodríguez‐Leor, Belén Cid-Álvarez, Armando Pérez de Prado, Xavier Rosselló, Soledad Ojeda, Ana Serrador, Ramon López‐Palop, Javier Martín‐Moreiras, José Ramón Rumoroso, Ángel Cequier, Borja Ibáñez, Ignacio Cruz‐González, Rafael Romaguera, Raúl Moreno, Manuel Villa, Rafael Ruíz-Salmerón, Francisco Molano, Carlos Sánchez, Érika Muñoz-García, Luís Íñigo, Juan Herrador, Antonio Gómez‐Menchero, Antonio Gómez‐Menchero, Juan Caballero, Soledad Ojeda, M Cárdenas, Livia Gheorghe, Jesús Oneto, Francisco Morales, Félix Valencia, José Ramón Ruíz, José A. Diarte, Pablo Avanzas, Juan Rondán, Vicente Peral, Lucía Vera Pernasetti, Julio Hernández, Francisco Bosa, Pedro Luis Martín Lorenzo, Francisco Jiménez, José M. de la Torre Hernández, Jesús Jiménez‐Mazuecos, Fernando Lozano, José Moreu, Enrique Novo, J. Morote Robles, Javier Martín Moreiras, Felipe Fernández‐Vázquez, Ignacio J. Amat‐Santos, Joan Antoni Gómez‐Hospital, Joan García‐Picart, Bruno García del Blanco, Ander Regueiro, Xavier Carrillo-Suárez, Helena Tizón‐Marcos, Mohsen Mohandes, J. Casanova, Víctor Agudelo-Montañez, Juan Francisco Muñoz, Juan Antonio Franco Peláez, Roberto del Castillo Medina, Pablo Salinas, Jaime Elı́zaga, Fernando Sarnago, Santiago Jiménez‐Valero, Fernando Rivero, J. Domínguez, Eduardo Alegría‐Barrero, Ángel Sánchez‐Recalde, Valeriano Ruíz, Eduardo Pinar, Eduardo Pinar, Ana Planas, Bernabé López Ledesma, Alberto Berenguer, Agustín Fernández‐Cisnal, Pablo Aguar, Francisco Pomar, Miguel Couselo Jerez, Francisco Torres, Ricardo Navarro García, Araceli Frutos, Juan M. Ruiz-Nodar, Koldobika García, Roberto Sáez, Alfonso Torres, Miren Tellería, Mario Sádaba, José Ramón López-Mínguez, Juan Carlos Rama Merchán, Javier Fernández-Portales, Ramiro Trillo, Guillermo Aldama, Saleta Fernández, Melisa Santás, María Pilar Portero Pérez,

Cardiac Arrest and Resuscitation

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.