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Impact of COVID-19 pandemic and diabetes on mechanical reperfusion in patients with STEMI: insights from the ISACS STEMI COVID 19 Registry
G. De Luca, M. Cercek, LO. Jensen, M. Vavlukis, L. Calmac, T. Johnson, G. Roura I Ferrer, V. Ganyukov, W. Wojakowski, C. von Birgelen, F. Versaci, J. Ten Berg, M. Laine, M. Dirksen, G. Casella, P. Kala, JL. Díez Gil, V. Becerra, C. De Simone, X....
Language English Country Great Britain
Document type Comparative Study, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't
NLK
BioMedCentral
from 2002-12-01
BioMedCentral Open Access
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Directory of Open Access Journals
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Free Medical Journals
from 2002
PubMed Central
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Europe PubMed Central
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from 2009-01-01
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from 2002-04-01
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- MeSH
- Time-to-Treatment trends MeSH
- Time Factors MeSH
- COVID-19 diagnosis epidemiology mortality MeSH
- Diabetes Mellitus diagnosis epidemiology mortality MeSH
- Hypertension epidemiology MeSH
- ST Elevation Myocardial Infarction mortality therapy MeSH
- Percutaneous Coronary Intervention adverse effects mortality trends MeSH
- Middle Aged MeSH
- Humans MeSH
- Hospital Mortality trends MeSH
- Registries MeSH
- Retrospective Studies MeSH
- Risk Factors MeSH
- Aged MeSH
- Treatment Outcome MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Research Support, Non-U.S. Gov't MeSH
- Comparative Study MeSH
- Geographicals
- Europe MeSH
BACKGROUND: It has been suggested the COVID pandemic may have indirectly affected the treatment and outcome of STEMI patients, by avoidance or significant delays in contacting the emergency system. No data have been reported on the impact of diabetes on treatment and outcome of STEMI patients, that was therefore the aim of the current subanalysis conducted in patients included in the International Study on Acute Coronary Syndromes-ST Elevation Myocardial Infarction (ISACS-STEMI) COVID-19. METHODS: The ISACS-STEMI COVID-19 is a retrospective registry performed in European centers with an annual volume of > 120 primary percutaneous coronary intervention (PCI) and assessed STEMI patients, treated with primary PCI during the same periods of the years 2019 versus 2020 (March and April). Main outcomes are the incidences of primary PCI, delayed treatment, and in-hospital mortality. RESULTS: A total of 6609 patients underwent primary PCI in 77 centers, located in 18 countries. Diabetes was observed in a total of 1356 patients (20.5%), with similar proportion between 2019 and 2020. During the pandemic, there was a significant reduction in primary PCI as compared to 2019, similar in both patients with (Incidence rate ratio (IRR) 0.79 (95% CI: 0.73-0.85, p < 0.0001) and without diabetes (IRR 0.81 (95% CI: 0.78-0.85, p < 0.0001) (p int = 0.40). We observed a significant heterogeneity among centers in the population with and without diabetes (p < 0.001, respectively). The heterogeneity among centers was not related to the incidence of death due to COVID-19 in both groups of patients. Interaction was observed for Hypertension (p = 0.024) only in absence of diabetes. Furthermore, the pandemic was independently associated with a significant increase in door-to-balloon and total ischemia times only among patients without diabetes, which may have contributed to the higher mortality, during the pandemic, observed in this group of patients. CONCLUSIONS: The COVID-19 pandemic had a significant impact on the treatment of patients with STEMI, with a similar reduction in primary PCI procedures in both patients with and without diabetes. Hypertension had a significant impact on PCI reduction only among patients without diabetes. We observed a significant increase in ischemia time and door-to-balloon time mainly in absence of diabetes, that contributed to explain the increased mortality observed in this group of patients during the pandemic. TRIAL REGISTRATION NUMBER: NCT04412655.
AUSL IRCCS Reggio Emilia Reggio Emilia Italy
Azienda Ospedaliero Universitaria Ospedali Riuniti Trieste Trieste Italy
Azienda Ospedaliero Universitaria Sassari Sassari Italy
Center for Cardiovascular Diseases Ohrid North Macedonia
Center Hospitalier Universitaire de Poitiers University Hospital Poitiers France
Central Hospital of Medical University of Lodz Łódź Poland
Centre for Intensive Internal Medicine University Medical Centre Ljubljana Slovenia
Clinic Emergency Hospital of Bucharest Bucharest Romania
Complexo Hospitaliero Universitario La Coruna La Coruna Spain
Department of Cardiology Medisch Spectrum Twente Thoraxcentrum Twente Enschede The Netherlands
Department of Statistical Sciences University of Padova Padova Italy
Division of Cardiology Attikon University Hospital Athens Greece
Division of Cardiology AziendaOspedaliera Ospedali Riuniti Marche Nord Pesaro Italy
Division of Cardiology CHU Lariboisière AP HP Paris 7 University INSERM UMRS 942 Paris France
Division of Cardiology Clinica Villa dei Fiori Acerra Italy
Division of Cardiology Complejo Hospitalario de Toledo Toledo Spain
Division of Cardiology Groupe Hospitalier Mutualiste de Grenoble Grenoble France
Division of Cardiology Heart Centre Turku Turku Finland
Division of Cardiology Helsinki University Central Hospital Helsinki Finland
Division of Cardiology Hospital Cabueñes Gijon Spain
Division of Cardiology Hospital Clinico Universitario de Valencia Valencia Spain
Division of Cardiology Hospital de Santa Cruz CHLO Carnaxide Carnaxide Portugal
Division of Cardiology Hospital la Paz Madrid Spain
Division of Cardiology Hospital Puerta del Mar Cadiz Spain
Division of Cardiology Hospital Universitario de Canarias Santa Cruz de Tenerife Spain
Division of Cardiology Juan Ramon Jimenez Hospital Huelva Spain
Division of Cardiology Medical University of Silezia Katowice Poland
Division of Cardiology Northwest Clinic Alkmaar The Netherlands
Division of Cardiology Odense Universitets Hospital Odense Danemark
Division of Cardiology Ospedale A Manzoni Lecco Lecco Italy
Division of Cardiology Ospedale degli Infermi ASL Biella Ponderano Italy
Division of Cardiology Ospedale F Spaziani Frosinone Italy
Division of Cardiology Ospedale G Moscati Aversa Italy
Division of Cardiology Ospedale Maggiore Bologna Italy
Division of Cardiology Ospedale S Maurizio Bolzano Ospedale S Maurizio Bolzano Italy
Division of Cardiology Ospedale San Giovanni di Dio e Ruggi d'Aragona Salerno Italy
Division of Cardiology Ospedale Sant'Anna Ferrara Italy
Division of Cardiology Ospedale Santa Maria delle Grazie Pozzuoli Italy
Division of Cardiology Ospedale Santa Maria Goretti Latina Italy
Division of Cardiology Oulu University Hospital Oulu Finland
Division of Cardiology St Antonius Hospital Nieuwegein The Netherlands
Division of Cardiology St Jan Hospital Brugge Belgium
Division of Cardiology UMC Utrecht Utrecht The Netherlands
H Universitario y Politécnico La Fe Valencia Spain
Hospital Clínico Universitario Virgen de la Victoria Málaga Spain
Hospital Germans Triasi Pujol Badalona Spain
Interventional Cardiology Unit Azienda Ospedaliera Sanitaria Parma Italy
Interventional Cardiology Unit Azienda Ospedaliero Universitaria Ospedali Riuniti Ancona Italy
Invasive Cardiology and Congenital Heart Disease Patras University Hospital Patras Greece
Maastricht University Medical Center Maastricht The Netherlands
Ospedale Santa Chiara di Trento Trento Italy
University Hospital Brno Medical Faculty of Masaryk University Brno Brno Czech Republic
References provided by Crossref.org
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