Division of Cardiology, Department of Cardiovascular Diseases - AUSL Romagna, S. Maria delle Croci Hospital, Ravenna.
Division of Cardiology, Department of Cardiovascular Diseases - AUSL Romagna, Degli Infermi Hospital, Rimini, Italy.
J Cardiovasc Med (Hagerstown). 2020 Nov;21(11):869-873. doi: 10.2459/JCM.0000000000001101.
The purpose of this study was to verify the impact on the number and characteristics of coronary invasive procedures for acute coronary syndrome (ACS) of two hub centers with cardiac catheterization facilities, during the first month of lockdown following the COVID-19 pandemic.
Procedural data of ACS patients admitted between 10 March and 10 April 2020 were compared with those of the same period of 2019.
We observed a 23.4% reduction in ACS admissions during 2020, with a decrease for both ST-elevation myocardial infarction (STEMI) (-5.6%) and non-ST-elevation myocardial infarction (-34.5%), albeit not statistically significant (P = 0.2). During the first 15 days of the examined periods, the reduction in ACS admissions reached 52.5% (-25% for STEMI and -70.3% for non-ST-elevation myocardial infarction, P = 0.04). Among STEMI patients, the rate of those with a time delay from symptoms onset longer than 180 min was significantly higher during the lockdown period (P = 0.01). Radiograph exposure (P = 0.01) was higher in STEMI patients treated in 2020 with a slightly higher amount of contrast medium (P = 0.1) and number of stents implanted (P = 0.1), whereas the number of treated vessels was reduced (P = 0.03). Percutaneous coronary intervention procedural success and in-hospital mortality were not different between the two groups and in STEMI patients (P NS for all).
During the early phase, the COVID-19 outbreak was associated with a lower rate of admissions for ACS, with a substantial impact on the time delay presentation of STEMI patients, but apparently without affecting the in-hospital outcomes.
本研究旨在验证在 COVID-19 大流行后的第一个月，拥有心脏导管插入术设施的两个中心对急性冠状动脉综合征（ACS）的冠状动脉介入治疗数量和特征的影响。
比较了 2020 年 3 月 10 日至 4 月 10 日期间和 2019 年同期入院的 ACS 患者的治疗数据。
我们观察到 2020 年 ACS 入院人数减少了 23.4%，ST 段抬高型心肌梗死（STEMI）（-5.6%）和非 ST 段抬高型心肌梗死（-34.5%）均有所下降，尽管差异无统计学意义（P=0.2）。在研究期间的前 15 天，ACS 入院人数减少了 52.5%（STEMI 减少了 25%，非 ST 段抬高型心肌梗死减少了 70.3%，P=0.04）。在 STEMI 患者中，发病时间超过 180 分钟的患者比例在封锁期间显著更高（P=0.01）。2020 年接受治疗的 STEMI 患者的 X 线曝光率（P=0.01）更高，造影剂用量（P=0.1）和支架植入数量（P=0.1）略高，而治疗血管数量减少（P=0.03）。两组患者的经皮冠状动脉介入治疗成功率和住院死亡率无差异，且在 STEMI 患者中也无差异（所有 P NS）。
在早期阶段，COVID-19 爆发与 ACS 入院率降低有关，对 STEMI 患者的发病时间延迟有重大影响，但显然不会影响住院期间的结局。
