Tokarek Tomasz, Dziewierz Artur, Malinowski Krzysztof Piotr, Rakowski Tomasz, Bartuś Stanisław, Dudek Dariusz, Siudak Zbigniew
Department of Cardiology and Cardiovascular Interventions, University Hospital, 2 Jakubowskiego St., 30-688 Krakow, Poland.
Center for Intensive Care and Perioperative Medicine, Jagiellonian University Medical College, 31-008 Krakow, Poland.
J Clin Med. 2021 Aug 30;10(17):3920. doi: 10.3390/jcm10173920.
Pandemic-specific protocols require additional time to prepare medical staff and catheterization laboratories. Thus, we sought to investigate treatment delay and clinical outcomes in COVID-19 positive and negative patients with ST-segment elevation myocardial infarction (STEMI) treated with percutaneous coronary intervention (PCI) during on- and off-hours. All consecutive patients with STEMI treated with PCI between 1 March and 31 December 2020 were enrolled in the analysis. A propensity score match was used to compare COVID-19 positive and negative patients for on- and off-hours. The study group was comprised of 877 paired patients treated during regular hours (every day 7:00 a.m. to 16:59 p.m.) and 418 matched pairs with PCI performed during off-hours (every day 17:00 p.m. to 06:59 a.m.) (ORPKI Polish National Registry). No difference in periprocedural mortality was observed between the two groups (on-hours: COVID-19 negative vs. COVID-19 positive: 17 (1.9%) vs. 11 (1.3%); = 0.3; off-hours: COVID-19 negative vs. COVID-19 positive: 4 (1.0%) vs. 7 (1.7%); = 0.5). Additionally, a similar rate of periprocedural complications was reported. Patients diagnosed with COVID-19 were exposed to longer time from first medical contact to angiography (on-hours: 133.8 (±137.1) vs. 117.1 (±135.8) (min); = 0.001) (off-hours: 148.1 (±201.6) vs. 112.2 (±138.7) (min); = 0.003). However, there was no influence of COVID-19 diagnosis on mortality and the prevalence of other periprocedural complications irrespective of time of intervention.
针对大流行的方案需要额外的时间来培训医护人员并准备导管插入实验室。因此，我们试图调查在工作时间和非工作时间接受经皮冠状动脉介入治疗（PCI）的ST段抬高型心肌梗死（STEMI）的COVID-19阳性和阴性患者的治疗延迟和临床结果。纳入了2020年3月1日至12月31日期间所有接受PCI治疗的连续性STEMI患者进行分析。采用倾向评分匹配法比较工作时间和非工作时间的COVID-19阳性和阴性患者。研究组包括877对在正常工作时间（每天上午7:00至下午16:59）接受治疗的配对患者和418对在非工作时间（每天下午17:00至上午06:59）进行PCI的匹配对（ORPKI波兰国家登记处）。两组之间围手术期死亡率无差异（工作时间：COVID-19阴性与COVID-19阳性：17例（1.9%）对11例（1.3%）；P = 0.3；非工作时间：COVID-19阴性与COVID-19阳性：4例（1.0%）对7例（1.7%）；P = 0.5）。此外，围手术期并发症发生率相似。被诊断为COVID-19的患者从首次医疗接触到血管造影的时间更长（工作时间：133.8（±137.1）对117.1（±135.8）（分钟）；P = 0.001）（非工作时间：148.1（±201.6）对112.2（±138.7）（分钟）；P = 0.003）。然而，无论干预时间如何，COVID-19诊断对死亡率和其他围手术期并发症的发生率均无影响。
