Key result
The early COVID-19 pandemic period was associated with a significant 14% decrease in median door-to-balloon time (37 vs 43 minutes) for patients with STEMI compared to the equivalent pre-pandemic period.
Why the study?
COVID-19 reduced patient visits for AMI and delayed response and intervention in several countries, prompting an evaluation of its effect on patient numbers, pain-to-door, and door-to-balloon times in South Korea.
Does the COVID-19 pandemic affect the presentation volume, pain-to-door time, and door-to-balloon time in patients with STEMI and NSTEMI?
Observational (n=808)
No
Does the COVID-19 pandemic affect the presentation volume, pain-to-door time, and door-to-balloon time in patients with STEMI and NSTEMI?
Effect estimate: 14% decrease
Absolute Event Rate: 37% vs 43%
p-value: p=0.004
The COVID-19 pandemic did not reduce the number of AMI patients presenting to a South Korean center, but was associated with a decreased door-to-balloon time for STEMI during the early pandemic phase.
Shorter early-pandemic STEMI door-to-balloon times may reflect workflow adaptations; leaves open sustainability and generalizability beyond this observational cohort.
Background The coronavirus disease 2019 (COVID-19) resulted in a marked decrease in the number of patient visits for acute myocardial infarction (AMI) and delayed patient response and intervention in several countries. This study evaluated the effect of the COVID-19 pandemic on the number of patients, patient response time (pain-to-door), and intervention time (door-to-balloon) for patients with ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI). Methods Patients with STEMI or NSTEMI visiting a hospital in South Korea who underwent primary coronary intervention during the COVID-19 pandemic (January 29, 2020, to December 31, 2020) were compared with those in the equivalent period in 2018 to 2019. Patient response and intervention times were compared for the COVID-19 pandemic window (2020) and the equivalent period in 2018 to 2019. Results We observed no decrease in the number of patients with STEMI ( P =0.50) and NSTEMI ( P =0.94) during the COVID-19 pandemic compared to that in the previous years. Patient response times (STEMI: P =0.34; NSTEMI: P =0.89) during the overall COVID-19 pandemic period did not differ significantly. However, we identified a significant decrease in time to intervention among patients with STEMI (14%; p<0.01) during the early COVID-19 pandemic. Conclusions We found that the number of patient with STEMI and NSTEMI was consistent during the COVID-19 pandemic and that no time delays in patient response and intervention occurred. However, the door-to-balloon time among patients with STEMI significantly reduced during the early COVID-19 pandemic, which could be attributed to reduced emergency care utilization during the early pandemic.
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Ryu et al. (2021) conducted an observational in Acute myocardial infarction (STEMI and NSTEMI) (n=808). COVID-19 pandemic period (2020) vs. Pre-COVID-19 period (2018-2019) was evaluated on Door-to-balloon time for STEMI patients during the early COVID-19 pandemic (Period-1) (14% decrease, p=0.004). The early COVID-19 pandemic period was associated with a significant 14% decrease in median door-to-balloon time (37 vs 43 minutes) for patients with STEMI compared to the equivalent pre-pandemic period.
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