Produção Nacional
Revisado por pares
COVID-19 pandemic, mechanical reperfusion and 30-day mortality in ST elevation myocardial infarction
2021; BMJ; Volume: 108; Issue: 6 Linguagem: Inglês
10.1136/heartjnl-2021-319750
ISSN1468-201X
AutoresGiuseppe De Luca, Magdy Algowhary, Berat Uğuz, Dinaldo Cavalcanti de Oliveira, V. I. Ganyukov, Zan Zimbakov, Miha Čerček, Lisette Okkels Jensen, Poay Huan Loh, Lucian Câlmâc, Gerard Roura-Ferrer, Alexandre Schaan de Quadros, Marek Milewski, Fortunato Scotto di Uccio, Clemens von Birgelen, Francesco Versaci, Jurriën M. ten Berg, Gianni Casella, Aaron Sung Lung Wong, Petr Kala, José Luis Díez Gil, Xavier Carrillo, Maurits T. Dirksen, Víctor Manuel Becerra‐Muñoz, Michael Lee, Dafsah Arifa Juzar, Rodrigo de Moura Joaquim, Roberto Paladino, Davor Miličić, Periklis Davlouros, Nikola Bakraceski, Filippo Zilio, Luca Donazzan, Adriaan O. Kraaijeveld, Gennaro Galasso, Árpád Lux, Lucia Marinucci, Vincenzo Guiducci, Maurizio Menichelli, Alessandra Scoccia, Aylin Hatice Yamaç, Kadir Uğur Mert, Xacobe Flores‐Ríos, Tomáš Kovárník, Michał Kidawa, José Moreu, Flavien Vincent, Enrico Fabris, Íñigo Lozano, Marco Boccalatte, Francisco Bosa Ojeda, Carlos Arellano Serrano, Gianluca Caiazzo, Giuseppe Cirrincione, Hsien‐Li Kao, Juan Sanchís, Luigi Vignali, Hélder Pereira, Stéphane Manzo‐Silberman, Santiago Ordóñez, Alev Arat Özkan, Bruno Scheller, Heidi Lehtola, Rui Campante Teles, Christos Mantis, Ylitalo Antti, João Silveira, Rodrigo Zoni, И. С. Бессонов, Stefano Savonitto, George Kochiadakis, Dimitrios Alexopoulos, C. Uribe, John Kanakakis, Benjamin Faurie, Gabriele Gabrielli, Alejandro Gutiérrez, Juan Pablo Bachini, Alex Rocha, Franckie Cc Tam, Alfredo E. Rodríguez, Antonia Anna Lukito, Veauthyelau Saint-Joy, Gustavo Pessah, Bernardino Tuccillo, Giuliana Cortese, Guido Parodi, Mohamed Abed Bouraghda, Elvin Kedhi, Pablo Lamelas, Harry Suryapranata, Matteo Nardin, Monica Verdoia,
Tópico(s)Cardiac Arrest and Resuscitation
ResumoThe initial data of the International Study on Acute Coronary Syndromes - ST Elevation Myocardial Infarction COVID-19 showed in Europe a remarkable reduction in primary percutaneous coronary intervention procedures and higher in-hospital mortality during the initial phase of the pandemic as compared with the prepandemic period. The aim of the current study was to provide the final results of the registry, subsequently extended outside Europe with a larger inclusion period (up to June 2020) and longer follow-up (up to 30 days).This is a retrospective multicentre registry in 109 high-volume primary percutaneous coronary intervention (PPCI) centres from Europe, Latin America, South-East Asia and North Africa, enrolling 16 674 patients with ST segment elevation myocardial infarction (STEMI) undergoing PPPCI in March/June 2019 and 2020. The main study outcomes were the incidence of PPCI, delayed treatment (ischaemia time >12 hours and door-to-balloon >30 min), in-hospital and 30-day mortality.In 2020, during the pandemic, there was a significant reduction in PPCI as compared with 2019 (incidence rate ratio 0.843, 95% CI 0.825 to 0.861, p 75 years) (p=0.015), and was not related to the peak of cases or deaths due to COVID-19. The heterogeneity among centres was high (p<0.001). Furthermore, the pandemic was associated with a significant increase in door-to-balloon time (40 (25-70) min vs 40 (25-64) min, p=0.01) and total ischaemia time (225 (135-410) min vs 196 (120-355) min, p<0.001), which may have contributed to the higher in-hospital (6.5% vs 5.3%, p<0.001) and 30-day (8% vs 6.5%, p=0.001) mortality observed during the pandemic.Percutaneous revascularisation for STEMI was significantly affected by the COVID-19 pandemic, with a 16% reduction in PPCI procedures, especially among older patients (about 20%), and longer delays to treatment, which may have contributed to the increased in-hospital and 30-day mortality during the pandemic.NCT04412655.
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