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韩国 COVID-19 时代经皮冠状动脉介入治疗 ST 段抬高型心肌梗死的治疗延迟和结局。

Treatment delay and outcomes of ST-segment elevation myocardial infarction treated by primary percutaneous coronary intervention during the COVID-19 era in South Korea.

机构信息

Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea.

Department of Cardiology, Chonnam National University Medical School, Gwangju, Korea.

出版信息

Korean J Intern Med. 2022 Jul;37(4):786-799. doi: 10.3904/kjim.2022.077. Epub 2022 Jun 28.

Abstract

BACKGROUND/AIMS: Little is known about the clinical characteristics and treatment outcomes of ST-segment elevation myocardial infarction (STEMI) in Korea during the coronavirus disease 2019 (COVID-19) era. We aimed to evaluate the clinical characteristics and treatment outcomes of patients with STEMI in the COVID-19 era.

METHODS

A total of 588 consecutive patients with STEMI who underwent primary percutaneous coronary intervention were included in this study. The patients were categorized into the COVID-19 (from January 20, 2020 to December 31, 2020) and control groups (from January 20, 2019 to December 31, 2019).

RESULTS

The COVID-19 group showed pre-hospital and in-hospital delays than the control group. The control group underwent more thrombus aspiration and had a higher proportion of left main coronary artery diseases, while the COVID-19 group had a higher proportion of multivessel diseases with a marked increase in the number and total length of stents than the control group. As for the prescribed medications, the COVID-19 group was administered more beta-blockers, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, and statins than the control group. The clinical outcomes were comparable between the groups, except for higher incidences of atrioventricular block and temporary pacemaker implantation in the COVID-19 group.

CONCLUSION

Reperfusion after STEMI treatment during the COVID-19 period was delayed; therefore, efforts should be made to improve on reperfusion.

摘要

背景/目的:关于 2019 年冠状病毒病(COVID-19)时期韩国 ST 段抬高型心肌梗死(STEMI)的临床特征和治疗结果知之甚少。我们旨在评估 COVID-19 时期 STEMI 患者的临床特征和治疗结果。

方法

本研究共纳入 588 例接受直接经皮冠状动脉介入治疗的连续 STEMI 患者。患者分为 COVID-19 组(2020 年 1 月 20 日至 12 月 31 日)和对照组(2019 年 1 月 20 日至 12 月 31 日)。

结果

COVID-19 组比对照组表现出更长的院前和院内延迟。对照组接受更多的血栓抽吸治疗,左主干冠状动脉疾病的比例更高,而 COVID-19 组多支血管疾病的比例更高,支架数量和总长度明显增加。在规定的药物治疗方面,COVID-19 组比对照组更多地使用β受体阻滞剂、血管紧张素转换酶抑制剂/血管紧张素受体阻滞剂和他汀类药物。两组临床结果相当,除 COVID-19 组房室传导阻滞和临时起搏器植入的发生率更高外。

结论

COVID-19 期间 STEMI 治疗后的再灌注延迟;因此,应努力改善再灌注。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cea1/9271717/8904876fdd0a/kjim-2022-077f1.jpg

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