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COVID-19 pandemic, mechanical reperfusion and 30-day mortality in ST elevation myocardial infarction
Heart ( IF 5.7 ) Pub Date : 2022-03-01 , DOI: 10.1136/heartjnl-2021-319750 Giuseppe De Luca , Magdy Algowhary , Berat Uguz , Dinaldo C Oliveira , Vladimir Ganyukov , Zan Zimbakov , Miha Cercek , Lisette Okkels Jensen , Poay Huan Loh , Lucian Calmac , Gerard Roura-Ferrer , Alexandre Quadros , Marek Milewski , Fortunato Scotto di Uccio , Clemens von Birgelen , Francesco Versaci , Jurriën Ten Berg , Gianni Casella , Aaron Sung Lung Wong , Petr Kala , Jose Luis Diez Gil , Xavier Carrillo , Maurits Theodoor Dirksen , Víctor Manuel Becerra-Muñoz , Michael Kang-yin Lee , Dafsah A Juzar , Rodrigo de Moura Joaquim , Roberto Paladino , Davor Milicic , Periklis Davlouros , Nikola Bakraceski , Filippo Zilio , Luca Donazzan , Adriaan O Kraaijeveld , Gennaro Galasso , Arpad Lux , Lucia Marinucci , Vincenzo Guiducci , Maurizio Menichelli , Alessandra Scoccia , Aylin Yamac , Kadir Ugur Mert , Xacobe Flores Rios , Tomas Kovarnik , Michal Kidawa , Jose Moreu , Vincent Flavien , Enrico Fabris , Iñigo Lozano Martìnez-Luengas , Marco Boccalatte , Francisco Bosa Ojeda , Carlos Arellano-Serrano , Gianluca Caiazzo , Giuseppe Cirrincione , Hsien-Li Kao , Juan Sanchis Fores , Luigi Vignali , Helder Pereira , Stéphane Manzo-Silberman , Santiago Ordonez , Alev Arat Özkan , Bruno Scheller , Heidi Lehtola , Rui Teles , Christos Mantis , Antti Ylitalo , Joao Antonio Brum Silveira , Rodrigo Zoni , Ivan Bessonov , Stefano Savonitto , George Kochiadakis , Dimitrios Alexopoulos , Carlos Uribe , John Kanakakis , Benjamin Faurie , Gabriele Gabrielli , Alejandro Gutiérrez , Juan Pablo Bachini , Alex Rocha , Franckie CC Tam , Alfredo Rodriguez , Antonia Lukito , Veauthyelau Saint-Joy , Gustavo Pessah , Bernardino Tuccillo , Giuliana Cortese , Guido Parodi , Mohamed Abed Bouraghda , Elvin Kedhi , Pablo Lamelas , Harry Suryapranata , Matteo Nardin , Monica Verdoia
Heart ( IF 5.7 ) Pub Date : 2022-03-01 , DOI: 10.1136/heartjnl-2021-319750 Giuseppe De Luca , Magdy Algowhary , Berat Uguz , Dinaldo C Oliveira , Vladimir Ganyukov , Zan Zimbakov , Miha Cercek , Lisette Okkels Jensen , Poay Huan Loh , Lucian Calmac , Gerard Roura-Ferrer , Alexandre Quadros , Marek Milewski , Fortunato Scotto di Uccio , Clemens von Birgelen , Francesco Versaci , Jurriën Ten Berg , Gianni Casella , Aaron Sung Lung Wong , Petr Kala , Jose Luis Diez Gil , Xavier Carrillo , Maurits Theodoor Dirksen , Víctor Manuel Becerra-Muñoz , Michael Kang-yin Lee , Dafsah A Juzar , Rodrigo de Moura Joaquim , Roberto Paladino , Davor Milicic , Periklis Davlouros , Nikola Bakraceski , Filippo Zilio , Luca Donazzan , Adriaan O Kraaijeveld , Gennaro Galasso , Arpad Lux , Lucia Marinucci , Vincenzo Guiducci , Maurizio Menichelli , Alessandra Scoccia , Aylin Yamac , Kadir Ugur Mert , Xacobe Flores Rios , Tomas Kovarnik , Michal Kidawa , Jose Moreu , Vincent Flavien , Enrico Fabris , Iñigo Lozano Martìnez-Luengas , Marco Boccalatte , Francisco Bosa Ojeda , Carlos Arellano-Serrano , Gianluca Caiazzo , Giuseppe Cirrincione , Hsien-Li Kao , Juan Sanchis Fores , Luigi Vignali , Helder Pereira , Stéphane Manzo-Silberman , Santiago Ordonez , Alev Arat Özkan , Bruno Scheller , Heidi Lehtola , Rui Teles , Christos Mantis , Antti Ylitalo , Joao Antonio Brum Silveira , Rodrigo Zoni , Ivan Bessonov , Stefano Savonitto , George Kochiadakis , Dimitrios Alexopoulos , Carlos Uribe , John Kanakakis , Benjamin Faurie , Gabriele Gabrielli , Alejandro Gutiérrez , Juan Pablo Bachini , Alex Rocha , Franckie CC Tam , Alfredo Rodriguez , Antonia Lukito , Veauthyelau Saint-Joy , Gustavo Pessah , Bernardino Tuccillo , Giuliana Cortese , Guido Parodi , Mohamed Abed Bouraghda , Elvin Kedhi , Pablo Lamelas , Harry Suryapranata , Matteo Nardin , Monica Verdoia
Objective The initial data of the International Study on Acute Coronary Syndromes - ST Elevation Myocardial Infarction COVID-19 showed in Europe a remarkable reduction in primary percutaneous coronary intervention procedures and higher in-hospital mortality during the initial phase of the pandemic as compared with the prepandemic period. The aim of the current study was to provide the final results of the registry, subsequently extended outside Europe with a larger inclusion period (up to June 2020) and longer follow-up (up to 30 days). Methods This is a retrospective multicentre registry in 109 high-volume primary percutaneous coronary intervention (PPCI) centres from Europe, Latin America, South-East Asia and North Africa, enrolling 16 674 patients with ST segment elevation myocardial infarction (STEMI) undergoing PPPCI in March/June 2019 and 2020. The main study outcomes were the incidence of PPCI, delayed treatment (ischaemia time >12 hours and door-to-balloon >30 min), in-hospital and 30-day mortality. Results In 2020, during the pandemic, there was a significant reduction in PPCI as compared with 2019 (incidence rate ratio 0.843, 95% CI 0.825 to 0.861, p<0.0001). This reduction was significantly associated with age, being higher in older adults (>75 years) (p=0.015), and was not related to the peak of cases or deaths due to COVID-19. The heterogeneity among centres was high (p<0.001). Furthermore, the pandemic was associated with a significant increase in door-to-balloon time (40 (25–70) min vs 40 (25–64) min, p=0.01) and total ischaemia time (225 (135–410) min vs 196 (120–355) min, p<0.001), which may have contributed to the higher in-hospital (6.5% vs 5.3%, p<0.001) and 30-day (8% vs 6.5%, p=0.001) mortality observed during the pandemic. Conclusion Percutaneous revascularisation for STEMI was significantly affected by the COVID-19 pandemic, with a 16% reduction in PPCI procedures, especially among older patients (about 20%), and longer delays to treatment, which may have contributed to the increased in-hospital and 30-day mortality during the pandemic. Trial registration number [NCT04412655][1]. Data are available upon reasonable request. [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT04412655&atom=%2Fheartjnl%2F108%2F6%2F458.atom
中文翻译：
COVID-19 大流行、ST 抬高型心肌梗死的机械再灌注和 30 天死亡率
目的 急性冠状动脉综合征 - ST 段抬高型心肌梗死 COVID-19 国际研究的初步数据显示，与大流行前相比，欧洲在大流行初期阶段的直接经皮冠状动脉介入治疗显着减少，院内死亡率较高时期。当前研究的目的是提供登记的最终结果，随后将其扩展到欧洲以外地区，并具有更长的纳入期（截至 2020 年 6 月）和更长的随访时间（最长 30 天）。方法 这是一项回顾性多中心登记，涉及来自欧洲、拉丁美洲、东南亚和北非的 109 个大容量初次经皮冠状动脉介入治疗 (PPCI) 中心，纳入了 16 674 名接受 PPPCI 的 ST 段抬高型心肌梗死 (STEMI) 患者。 2019 年 3 月/6 月和 2020 年。主要研究结果是 PPCI 的发生率、延迟治疗（缺血时间 > 12 小时和门到球囊 > 30 分钟）、院内死亡率和 30 天死亡率。结果 2020 年疫情期间，PPCI 较 2019 年显着下降（发生率比 0.843，95% CI 0.825 至 0.861，p<0.0001）。这种下降与年龄显着相关，老年人（>75 岁）的下降幅度更高（p=0.015），并且与 COVID-19 导致的病例或死亡高峰无关。中心之间的异质性很高（p<0.001）。此外，大流行与门到球囊时间（40（25-70）分钟 vs 40（25-64）分钟，p=0.01）和总缺血时间（225（135-410）分钟）显着增加相关。 vs 196 (120–355) 分钟，p<0.001），这可能导致住院时间（6.5% vs 5.3%，p<0.001）和 30 天（8% vs 6.5%，p=0.001）较高大流行期间观察到的死亡率。结论 STEMI 的经皮血运重建术受到 COVID-19 大流行的显着影响，PPCI 手术减少了 16%，尤其是老年患者（约 20%），并且治疗延迟时间更长，这可能导致住院人数增加以及大流行期间 30 天的死亡率。试用注册号[NCT04412655][1]。数据可根据合理要求提供。[1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT04412655&atom=%2Fheartjnl%2F108%2F6%2F458.atom
更新日期：2022-02-24
中文翻译：
COVID-19 大流行、ST 抬高型心肌梗死的机械再灌注和 30 天死亡率
目的 急性冠状动脉综合征 - ST 段抬高型心肌梗死 COVID-19 国际研究的初步数据显示，与大流行前相比，欧洲在大流行初期阶段的直接经皮冠状动脉介入治疗显着减少，院内死亡率较高时期。当前研究的目的是提供登记的最终结果，随后将其扩展到欧洲以外地区，并具有更长的纳入期（截至 2020 年 6 月）和更长的随访时间（最长 30 天）。方法 这是一项回顾性多中心登记，涉及来自欧洲、拉丁美洲、东南亚和北非的 109 个大容量初次经皮冠状动脉介入治疗 (PPCI) 中心，纳入了 16 674 名接受 PPPCI 的 ST 段抬高型心肌梗死 (STEMI) 患者。 2019 年 3 月/6 月和 2020 年。主要研究结果是 PPCI 的发生率、延迟治疗（缺血时间 > 12 小时和门到球囊 > 30 分钟）、院内死亡率和 30 天死亡率。结果 2020 年疫情期间，PPCI 较 2019 年显着下降（发生率比 0.843，95% CI 0.825 至 0.861，p<0.0001）。这种下降与年龄显着相关，老年人（>75 岁）的下降幅度更高（p=0.015），并且与 COVID-19 导致的病例或死亡高峰无关。中心之间的异质性很高（p<0.001）。此外，大流行与门到球囊时间（40（25-70）分钟 vs 40（25-64）分钟，p=0.01）和总缺血时间（225（135-410）分钟）显着增加相关。 vs 196 (120–355) 分钟，p<0.001），这可能导致住院时间（6.5% vs 5.3%，p<0.001）和 30 天（8% vs 6.5%，p=0.001）较高大流行期间观察到的死亡率。结论 STEMI 的经皮血运重建术受到 COVID-19 大流行的显着影响，PPCI 手术减少了 16%，尤其是老年患者（约 20%），并且治疗延迟时间更长，这可能导致住院人数增加以及大流行期间 30 天的死亡率。试用注册号[NCT04412655][1]。数据可根据合理要求提供。[1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT04412655&atom=%2Fheartjnl%2F108%2F6%2F458.atom
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