Key result
Implementation of a dedicated COVID-19 primary angioplasty protocol for STEMI maintained similar target times for reperfusion, including a median first medical contact to wire crossing time of 61 minutes versus 67.5 minutes prepandemic (p=0.12).
Why the study?
Critical times in STEMI management may be influenced by infection control protocols required during the COVID-19 outbreak.
Does a dedicated COVID-19 primary percutaneous coronary intervention protocol impact reperfusion time intervals and short-term outcomes in patients with ST-segment elevation myocardial infarction?
Observational (n=324)
No
Does a dedicated COVID-19 primary percutaneous coronary intervention protocol impact reperfusion time intervals and short-term outcomes in patients with ST-segment elevation myocardial infarction?
Implementation of a dedicated COVID-19 PPCI protocol allowed for similar target times for reperfusion and short-term clinical outcomes compared to the prepandemic era, without compromising staff safety.
Answers are grounded in this paper and cite their sources.
Supports dedicated COVID-adapted STEMI protocols to preserve reperfusion times; leaves open confirmation in larger prospective studies.
BACKGROUND: Primary percutaneous coronary intervention (PPCI) as the treatment of choice for ST‑segment elevation myocardial infarction (STEMI) should be rapidly performed. It is necessary to use preventive strategies during the coronavirus disease 2019 (COVID‑19) outbreak, which is an ongoing global concern. However, critical times in STEMI management may be influenced by the implementation of infection control protocols. AIMS: We aimed to investigate the impact of our dedicated COVID‑19 PPCI protocol on time components related to STEMI care and catheterization laboratory personnel safety. A subendpoint analysis to compare patient outcomes at a median time of 70 days during the pandemic with those of patients treated in the preceding year was another objective of our study. METHODS: Patients with STEMI who underwent PPCI were included in this study. Chest computed tomography (CT) and real‑time reverse transcriptase-polymerase chain reaction (rRT‑PCR) tests were performed in patients suspected of having COVID‑19. A total of 178 patients admitted between February 29 and April 30, 2020 were compared with 146 patients admitted between March 1 and April 30, 2019. RESULTS: Severe acute respiratory syndrome coronavirus 2 infection was confirmed by rRT‑PCR in 7 cases. In 6 out of 7 patients, CT was indicative of COVID‑19. There were no differences between the study groups regarding critical time intervals for reperfusion in STEMI. The 70‑day mortality rate before and during the pandemic was 2.73% and 4.49%, respectively (P = 0.4). CONCLUSIONS: The implementation of the dedicated COVID‑19 PPCI protocol in patients with STEMI allowed us to achieve similar target times for reperfusion, short‑term clinical outcomes, and staff safety as in the prepandemic era.
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Salarifar et al. (2020) conducted an observational in ST-segment elevation myocardial infarction (n=324). Dedicated COVID-19 primary angioplasty protocol vs. Prepandemic standard of care was evaluated on First medical contact to wire crossing time (median minutes) (p=0.12). Implementation of a dedicated COVID-19 primary angioplasty protocol for STEMI maintained similar target times for reperfusion, including a median first medical contact to wire crossing time of 61 minutes versus 67.5 minutes prepandemic (p=0.12).
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