Key result
COVID-19 pandemic consistently prolonged STEMI onset-to-arrival times, with mixed effects on door-to-balloon times and mortality.
Why the study?
The specific implications of the COVID-19 pandemic on door-to-balloon and symptom onset-to-balloon times in patients with ST-elevation MI were not well-known.
Does the COVID-19 pandemic era increase door-to-balloon time and mortality in patients presenting with ST-elevation MI compared to the pre-COVID-19 era?
Does the COVID-19 pandemic era increase door-to-balloon time and mortality in patients presenting with ST-elevation MI compared to the pre-COVID-19 era?
The COVID-19 pandemic generally increased symptom-to-hospital arrival times for STEMI patients, with variable impacts on door-to-balloon times and mortality.
Delays in STEMI presentation during pandemics warrant sustained public education; leaves open whether targeted interventions can standardize door-to-balloon times and mortality.
In patients presenting with ST-elevation MI, prompt primary coronary intervention is the preferred treatment modality. Several studies have described improved outcomes in patients with door-to-balloon (D2B) and symptom onset-to-balloon (OTB) times of less than 2 hours, but the specific implications of the coronavirus disease 2019 (COVID-19) pandemic on D2B and OTB times are not well-known. This review aims to evaluate the impact of COVID-19 on D2B time and elucidate both the factors that delay D2B time and strategies to improve D2B time in the contemporary era. The search was directed to identify articles discussing the significance of D2B times before and during COVID-19, from the initialization of the database to December 1, 2020. The majority of studies found that onset-of-symptom to hospital arrival time increased in the COVID-19 era, whereas D2B time and mortality were unchanged in some studies and increased in others.
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Mously et al. (2021) conducted a review in ST-elevation myocardial infarction (STEMI). COVID-19 pandemic era vs. Pre-COVID-19 era was evaluated on Door-to-balloon (D2B) time and symptom onset-to-balloon (OTB) time. The COVID-19 pandemic consistently increased symptom onset-to-hospital arrival times for STEMI patients, while its impact on door-to-balloon times and mortality was mixed across reviewed studies.
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