Management and Outcomes of Patients With STEMI During the COVID-19 Pandemic in China,Journal of the American College of Cardiology

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Management and Outcomes of Patients With STEMI During the COVID-19 Pandemic in China
Journal of the American College of Cardiology ( IF 21.7 ) Pub Date : 2020-09-01 , DOI: 10.1016/j.jacc.2020.06.039
Dingcheng Xiang ₁ , Xin Xiang ₂ , Wei Zhang ₃ , Shaodong Yi ₁ , Jinxia Zhang ₁ , Xiaolong Gu ₁ , Yawei Xu ₄ , Kai Huang ₅ , Xi Su ₆ , Bo Yu ₇ , Yan Wang ₈ , Weiyi Fang ₉ , Yong Huo ₁₀ , Junbo Ge ₁₁

Affiliation

Department of Cardiology, General Hospital of Southern Theatre Command of PLA, Guangzhou, China.
Graduate School of Arts and Sciences, Harvard University, Cambridge, Massachusetts.
Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China.
Department of Cardiology, 10th Hospital of Tongji University, Shanghai, China.
Department of Cardiology, Union Hospital of Huazhong University of Science and Technology, Wuhan, China.
Department of Cardiology, Wuhan Asia Heart Hospital, Wuhan, China.
Department of Cardiology, Key Laboratories of Education Ministry for Myocardial Ischemia Mechanism and Treatment, 2nd Affiliated Hospital of Harbin Medical University, Harbin, China.
Department of Cardiology, Xiamen Heart Center, Xiamen, China.
Department of Cardiology, Shanghai Dongfang Hospital, Shanghai, China.
Department of Cardiology, Peking University First Hospital, Beijing, China.
Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, China.

Abstract Background ST-segment elevation myocardial infarction (STEMI) is a fatal cardiovascular emergency requiring rapid reperfusion treatment. During the coronavirus disease-2019 (COVID-19) pandemic, medical professionals need to strike a balance between providing timely treatment for STEMI patients and implementing infection control procedures to prevent nosocomial spread of COVID-19 among health care workers and other vulnerable cardiovascular patients. Objectives This study evaluates the impact of the COVID-19 outbreak and China Chest Pain Center’s modified STEMI protocol on the treatment and prognosis of STEMI patients in China. Methods Based on the data of 28,189 STEMI patients admitted to 1,372 Chest Pain Centers in China between December 27, 2019 and February 20, 2020, the study analyzed how the COVID-19 outbreak and China Chest Pain Center’s modified STEMI protocol influenced the number of admitted STEMI cases, reperfusion strategy, key treatment time points, and in-hospital mortality and heart failure for STEMI patients. Results The COVID-19 outbreak reduced the number of STEMI cases reported to China Chest Pain Centers. Consistent with China Chest Pain Center’s modified STEMI protocol, the percentage of patients undergoing primary percutaneous coronary intervention declined while the percentage of patients undergoing thrombolysis increased. With an average delay of approximately 20 min for reperfusion therapy, the rate of in-hospital mortality and in-hospital heart failure increased during the outbreak, but the rate of in-hospital hemorrhage remained stable. Conclusions There were reductions in STEMI patients’ access to care, delays in treatment timelines, changes in reperfusion strategies, and an increase of in-hospital mortality and heart failure during the COVID-19 pandemic in China.

更新日期：2020-09-01

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