Custodio-Sánchez Piero, Miranda David, Murillo Luis
Servicio de Cardiología. Unidad de Cardiología Intervencionista. Hospital Nacional Almanzor Aguinaga Asenjo Essalud, Chiclayo, Perú. Servicio de Cardiología Unidad de Cardiología Intervencionista Hospital Nacional Almanzor Aguinaga Asenjo Essalud Chiclayo Perú.
Servicio de Cardiología Clínica. Instituto Nacional Cardiovascular INCOR. Lima, Perú. Servicio de Cardiología Clínica Instituto Nacional Cardiovascular INCOR Lima Perú.
Arch Peru Cardiol Cir Cardiovasc. 2020 Jun 29;1(2):67-74. doi: 10.47487/apcyccv.v1i2.22. eCollection 2020 Apr-Jun.
To compare the number of admissions, clinical features and therapeutic outcomes of patients treated for acute ST-segment elevation myocardial infarction (STEMI), before and after the COVID-19 pandemic state of emergency in Peru.
Observational analytical study of retrospective cohorts, derivated from the PEruvian Registry of ST-segment Elevation Myocardial Infarction II (PERSTEMI II). We compared the patients treated for STEMI, between 45 days before and during the first 45 days of the COVID-19 state of emergency in Peru.
During the first 45 days of the COVID-19 state of emergency, the team found a 59% decrease on the number of admissions for STEMI. There was a larger proportion of patients with high blood pressure and dyslipidemia. We noticed a decreasing trend in the access to reperfusion therapies (73% vs. 66.6%); the fibrinolysis was the most commonly used therapy. The most frequent reason for no reperfusion was the late onset >24 hours (41.7%, p=0.004). There was a trend of time reduction to first medical contact and less ischemia time to reperfusion. A lower incidence of post-infarction heart failure was registered. The mortality was similar in both groups (3.4% vs. 2.7%).
COVID-19 pandemic in Peru has generated a significant reduction of STEMI admissions and a trend in less use of reperfusion therapies. The late onset of patients was the most common reason of not reperfusion.
比较秘鲁新冠疫情紧急状态前后,急性ST段抬高型心肌梗死(STEMI)患者的入院人数、临床特征及治疗结果。
基于秘鲁ST段抬高型心肌梗死登记处II(PERSTEMI II)进行回顾性队列观察分析研究。比较了秘鲁新冠疫情紧急状态前45天和紧急状态开始的前45天内接受STEMI治疗的患者情况。
在新冠疫情紧急状态的前45天,研究团队发现STEMI入院人数减少了59%。高血压和血脂异常患者的比例更高。我们注意到接受再灌注治疗的比例呈下降趋势(73%对66.6%);纤维蛋白溶解是最常用的治疗方法。未进行再灌注治疗的最常见原因是发病时间超过24小时(41.7%,p = 0.004)。首次医疗接触时间有缩短趋势,再灌注时的缺血时间也缩短。梗死后期心力衰竭的发生率较低。两组的死亡率相似(3.4%对2.7%)。
秘鲁的新冠疫情导致STEMI入院人数显著减少,再灌注治疗的使用也有减少趋势。患者发病时间晚是未进行再灌注治疗的最常见原因。