Aims 

The purpose of this study was to verify the impact on the number and characteristics of coronary invasive procedures for acute coronary syndrome (ACS) of two hub centers with cardiac catheterization facilities, during the first month of lockdown following the COVID-19 pandemic.

Materials and methods 

Procedural data of ACS patients admitted between 10 March and 10 April 2020 were compared with those of the same period of 2019.

Results 

We observed a 23.4% reduction in ACS admissions during 2020, with a decrease for both ST-elevation myocardial infarction (STEMI) (–5.6%) and non-ST-elevation myocardial infarction (–34.5%), albeit not statistically significant (P = 0.2). During the first 15 days of the examined periods, the reduction in ACS admissions reached 52.5% (–25% for STEMI and –70.3% for non-ST-elevation myocardial infarction, P = 0.04). Among STEMI patients, the rate of those with a time delay from symptoms onset longer than 180 min was significantly higher during the lockdown period (P = 0.01). Radiograph exposure (P = 0.01) was higher in STEMI patients treated in 2020 with a slightly higher amount of contrast medium (P = 0.1) and number of stents implanted (P = 0.1), whereas the number of treated vessels was reduced (P = 0.03). Percutaneous coronary intervention procedural success and in-hospital mortality were not different between the two groups and in STEMI patients (P NS for all).

Conclusion 

During the early phase, the COVID-19 outbreak was associated with a lower rate of admissions for ACS, with a substantial impact on the time delay presentation of STEMI patients, but apparently without affecting the in-hospital outcomes.

中文翻译：

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两个意大利大批量转诊中心的COVID-19大流行对冠状动脉介入手术的影响

目的 

这项研究的目的是验证在COVID-19 大流行后的禁闭期第一个月期间，对使用心脏导管插入设施的两个中心中心对急性冠脉综合征（ACS）的冠状动脉侵入性手术的数量和特征的影响。

材料和方法 

将2020年3月10日至2020年4月10日之间收治的ACS患者的手术数据与2019年同期进行比较。

结果 

我们观察到2020年ACS的入院人数减少23.4％，ST抬高型心肌梗死（STEMI）（–5.6％）和非ST抬高型心肌梗死（–34.5％）均减少，尽管无统计学意义（P = 0.2）。在检查期的前15天中，ACS入院率下降了52.5％（对于STEMI为–25％，对于非ST抬高型心肌梗死为–70.3％，P = 0.04）。在STEMI患者中，症状发作时间延迟超过180分钟的患者在锁定期间明显更高（P = 0.01）。2020年STEMI患者的X光片暴露量（P = 0.01）更高，而造影剂的剂量则略高（P= 0.1）和植入的支架数量（P = 0.1），而治疗的血管数量减少（P = 0.03）。两组之间以及STEMI患者（全部为P NS）中，经皮冠状动脉介入治疗的手术成功率和院内死亡率无差异。

结论 

在早期阶段，COVID-19的暴发与ACS的入院率较低有关，对STEMI患者的延迟诊治时间有实质性影响，但显然不影响医院的预后。