Department of Cardiology, Fujita Health University Bantane Hospital.
Department of Cardiology, Aichi Medical University.
Circ J. 2020 Nov 25;84(12):2185-2189. doi: 10.1253/circj.CJ-20-0708. Epub 2020 Sep 19.
With the rapid spread of COVID-19, hospitals providing percutaneous coronary intervention (PCI) were placed in unique and unfamiliar circumstances. This study evaluated variations in the treatment of coronary artery disease according to time course of the COVID-19 pandemic in Japan.
The Japanese Association of Cardiovascular Intervention and Therapeutics performed serial surveys during the pandemic (in mid-April, late-April and mid-May 2020) with queries regarding the implementation of PCI. Hospitals were asked about their treatment strategies for elective PCI and emergency PCI for ST-elevation myocardial infarction (STEMI) and high-risk acute coronary syndrome (ACS) patients. Most hospitals opted to perform primary PCI in the usual manner at the beginning of the pandemic. As the pandemic progressed, hospitals in the 7 populated areas downgraded the performance of PCI for chronic coronary syndrome and high-risk ACS, but not for STEMI patients. After the state of emergency was lifted in most prefectures in mid-May, the rate of PCI gradually normalized. Screening tests, such as polymerase chain reaction and chest computed tomography, in ACS were frequently used.
The COVID-19 pandemic greatly affected PCI treatment in Japan. However, even in the most critical situations during the pandemic, most institutions continued to perform primary PCI normally for STEMI patients.
随着 COVID-19 的迅速传播,提供经皮冠状动脉介入治疗(PCI)的医院面临着独特而陌生的情况。本研究评估了日本 COVID-19 大流行期间根据时间进程治疗冠状动脉疾病的变化。
日本心血管介入治疗协会在大流行期间(2020 年 4 月中旬、4 月下旬和 5 月中旬)进行了一系列调查,询问了 PCI 的实施情况。医院被问及他们对择期 PCI 和 ST 段抬高型心肌梗死(STEMI)和高危急性冠状动脉综合征(ACS)患者的急诊 PCI 的治疗策略。大多数医院在大流行开始时选择以通常的方式进行直接 PCI。随着大流行的发展,7 个人口稠密地区的医院降低了慢性冠状动脉综合征和高危 ACS 的 PCI 性能,但对 STEMI 患者没有影响。5 月中旬,大多数县解除紧急状态后,PCI 的比例逐渐恢复正常。ACS 中的聚合酶链反应和胸部计算机断层扫描等筛查试验经常使用。
COVID-19 大流行对日本的 PCI 治疗产生了重大影响。然而,即使在大流行期间最关键的情况下,大多数机构仍继续为 STEMI 患者正常进行直接 PCI。