Department of Cardiology, Sakurakai Takahashi Hospital.
Department of Cardiology, Eiwakai Izumikawa Hospital.
Int Heart J. 2021;62(6):1230-1234. doi: 10.1536/ihj.21-308.
During the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, patients with ST-elevation myocardial infarction (STEMI) should be treated as possibly infected individuals. Therefore, more time is considered necessary to conduct primary percutaneous coronary intervention (PCI). In this study, we sought to evaluate the impact of the SARS-CoV-2 pandemic on primary PCI for STEMI. Between March 2019 and March 2021, 259 patients with STEMI underwent primary PCI. Patients were divided into 2 groups: the pre-pandemic group (March 2019-February 2020) and the pandemic group (March 2020-February 2021). The patient demographics, reperfusion time including onset-to-door time, door-to-balloon time (DTBT), computed tomography (CT), peak creatinine phosphokinase (CPK), and 30-day mortality rate were investigated. The mean age of the patients was 70.4 ± 12.9 years, and 71.6% were male. There were 117 patients before the pandemic and 142 during the pandemic. The median DTBT was 29 (21.25-41.25) minutes before the pandemic and 48 minutes (31-73 minutes) during the pandemic (P < 0.001). The median door-to-catheter-laboratory time was 13.5 (10-18.75) minutes before the pandemic and 29.5 (18-47.25) minutes during the pandemic (P < 0.001). CT evaluation was performed before PCI in 39 (33.3%) patients and 63 (44.4%) patients (P = 0.08); their peak CPK levels were 1480 (358-2737.5) IU and 1363 (621-2722.75) IU (P = 0.56), and the 30-day mortality rates were 4.3% and 2.1% (P = 0.48), respectively. The SARS-CoV-2 pandemic changed the diagnostic procedure in the emergency department and affected the DTBT in patients with STEMI. Nonetheless, no adverse effects on the 30-day mortality rate were observed.
在严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）大流行期间，ST 段抬高型心肌梗死（STEMI）患者应被视为可能感染的个体。因此，进行经皮冠状动脉介入治疗（PCI）需要更多的时间。在这项研究中，我们旨在评估 SARS-CoV-2 大流行对 STEMI 患者的直接 PCI 治疗的影响。2019 年 3 月至 2021 年 3 月，259 例 STEMI 患者接受了直接 PCI。患者分为 2 组：大流行前组（2019 年 3 月至 2020 年 2 月）和大流行组（2020 年 3 月至 2021 年 2 月）。调查了患者的人口统计学特征、再灌注时间（包括发病至门时间、门至球囊时间[DTBT]）、计算机断层扫描（CT）、肌酸磷酸激酶峰值（CPK）和 30 天死亡率。患者的平均年龄为 70.4 ± 12.9 岁，71.6%为男性。大流行前有 117 例，大流行时有 142 例。大流行前的中位 DTBT 为 29（21.25-41.25）分钟，大流行时为 48 分钟（31-73 分钟）（P<0.001）。大流行前的门到导管实验室时间中位数为 13.5（10-18.75）分钟，大流行时为 29.5（18-47.25）分钟（P<0.001）。直接 PCI 前有 39（33.3%）例患者和 63（44.4%）例患者进行了 CT 评估（P=0.08）；他们的 CPK 峰值分别为 1480（358-2737.5）IU 和 1363（621-2722.75）IU（P=0.56），30 天死亡率分别为 4.3%和 2.1%（P=0.48）。SARS-CoV-2 大流行改变了急诊科的诊断程序，并影响了 STEMI 患者的 DTBT。但是，30 天死亡率无不良影响。
