Produção Nacional
Revisado por pares
Age-Related Effects of COVID-19 Pandemic on Mechanical Reperfusion and 30-Day Mortality for STEMI: Results of the ISACS-STEMI COVID-19 Registry
2023; Multidisciplinary Digital Publishing Institute; Volume: 12; Issue: 6 Linguagem: Inglês
10.3390/jcm12062116
ISSN2077-0383
AutoresGiuseppe De Luca, Magdy Algowhary, Berat Uğuz, Dinaldo Cavalcanti de Oliveira, V. I. Ganyukov, Oliver Busljetik, Miha Čerček, Lisette Okkels Jensen, Poay Huan Loh, Lucian Câlmâc, Gerard Roura Ferrer, Alexandre Schaan de Quadros, Marek Milewski, Fortunato Scotto D’Uccio, Clemens von Birgelen, Francesco Versaci, Jurriën M. ten Berg, Gianni Casella, Aaron Wong Sung Lung, 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 Lehitola, Rui Campante Teles, Christos Mantis, Ylitalo Antti, João Silveira, Rodrigo Zoni, И. С. Бессонов, Giuseppe Uccello, George Kochiadakis, Dimitrios Alexopulos, C. Uribe, John Kanakakis, Benjamin Faurie, Gabriele Gabrielli, Alejandro Gutiérrez, Juan Pablo Bachini, Alex Rocha, Frankie Chor-Cheung Tam, Alfredo E. Rodríguez, Antonia Anna Lukito, Veauthyelau Saint-Joy, Gustavo Pessah, Andrea Tuccillo, Alfonso Ielasi, Giuliana Cortese, Guido Parodi, Mohammed Abed Burgadha, Elvin Kedhi, Pablo Lamelas, Harry Suryapranata, Matteo Nardin, Monica Verdoia,
Tópico(s)Acute Myocardial Infarction Research
ResumoThe constraints in the management of patients with ST-segment elevation myocardial infarction (STEMI) during the COVID-19 pandemic have been suggested to have severely impacted mortality levels. The aim of the current analysis is to evaluate the age-related effects of the COVID-19 pandemic on mechanical reperfusion and 30-day mortality for STEMI within the registry ISACS-STEMI COVID-19.This retrospective multicenter registry was performed in high-volume PPCI centers on four continents and included STEMI patients undergoing PPCI in March-June 2019 and 2020. Patients were divided according to age (< or ≥75 years). The main outcomes were the incidence and timing of PPCI, (ischemia time longer than 12 h and door-to-balloon longer than 30 min), and in-hospital or 30-day mortality.We included 16,683 patients undergoing PPCI in 109 centers. In 2020, during the pandemic, there was a significant reduction in PPCI as compared to 2019 (IRR 0.843 (95%-CI: 0.825-0.861, p < 0.0001). We found a significant age-related reduction (7%, p = 0.015), with a larger effect on elderly than on younger patients. Furthermore, we observed significantly higher 30-day mortality during the pandemic period, especially among the elderly (13.6% vs. 17.9%, adjusted HR (95% CI) = 1.55 [1.24-1.93], p < 0.001) as compared to younger patients (4.8% vs. 5.7%; adjusted HR (95% CI) = 1.25 [1.05-1.49], p = 0.013), as a potential consequence of the significantly longer ischemia time observed during the pandemic.The COVID-19 pandemic had a significant impact on the treatment of patients with STEMI, with a 16% reduction in PPCI procedures, with a larger reduction and a longer delay to treatment among elderly patients, which may have contributed to increase in-hospital and 30-day mortality during the pandemic.
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