Key result
COVID-19 pandemic linked to ~79% higher in-hospital mortality and prolonged onset-to-door time in STEMI patients.
Why the study?
The study aimed to evaluate the impact of the COVID-19 pandemic on care quality indicators in STEMI patients undergoing primary PCI, including onset-to-door time, time from admission to wire crossing, and in-hospital mortality.
Does the COVID-19 pandemic increase treatment delays and in-hospital mortality in STEMI patients undergoing pPCI?
Cohort (n=480)
No
Does the COVID-19 pandemic increase treatment delays and in-hospital mortality in STEMI patients undergoing pPCI?
Absolute Event Rate: 14.09% vs 7.85%
p-value: p=0.033
The COVID-19 pandemic significantly prolonged STEMI treatment times and was associated with a near doubling of in-hospital mortality.
Pandemic-related STEMI delays may raise mortality; leaves open whether system interventions mitigate risks in future crises.
Background The most reliable care quality indicators for STEMI patients undergoing primary percutaneous coronary intervention (pPCI) include onset-to-door time (OTDT), time from admission to wire crossing and in-hospital mortality. Aims Our study aimed to evaluate the impact of the COVID-19 pandemic on these selected care quality indicators in pre-pandemic and pandemic groups of STEMI patients. Methods This single-centre, retrospective study, enrolled 480 STEMI patients, aged 63.59 ± 12.44 years treated with pPCI across two time frames: pre-pandemic ( n = 331) and pandemic ( n = 149). The evaluation criteria included OTDT, time from admission to PCI-mediated reperfusion, in-hospital mortality, and predictors of time delays. Results Our study revealed a significant increases in OTDT (median 3 h; IQR 1.5–12.0 vs. median 5 h; IQR 2.0–24.0, p = 0.011) and time from admission to wire crossing (median 92 min; IQR 65.0–187.0 vs. median 115.0; IQR 73.0–233.0, p = 0.025), in the COVID-19 pandemic group of STEMI patients, compared to the pre-pandemic subset. We also observed an increase in in-hospital mortality (7.85% vs. 14.09%, p = 0.033) and incidence of cardiogenic shock/cardiac arrest (16.62% vs. 26.85%, p = 0.009). Additionally, the proportion of patients with prolonged OTDT (24.45% vs. 35.71%, p = 0.019) and extended time from admission to PCI-mediated reperfusion (51.96% vs. 65.77%, p = 0.005) increased during the pandemic period. Conclusions The study's results indicated prolonged OTDT and admission-to-wire crossing times, increased in-hospital mortality, and the higher frequency of cardiogenic shock/cardiac arrest during the COVID-19 pandemic. These findings demonstrate the negative impact of the pandemic on treatment times and outcomes for patients diagnosed with STEMI.
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Bychowski et al. (2025) conducted a cohort in ST-segment elevation myocardial infarction (STEMI) (n=480). COVID-19 pandemic period vs. Pre-pandemic period was evaluated on In-hospital mortality (p=0.033). The COVID-19 pandemic was associated with increased in-hospital mortality (14.09% vs. 7.85%, p=0.033) and prolonged onset-to-door time among STEMI patients undergoing primary PCI.
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