Key result
Primary PCI remains safe for STEMI during COVID-19 with ~2% in-hospital mortality and no staff infections.
Why the study?
During the COVID-19 pandemic, the appropriate reperfusion strategy for patients presenting with STEMI remained unclear.
Is primary PCI safe and effective for STEMI patients during the COVID-19 pandemic when using recommended safety measures?
Observational (n=48)
No
Is primary PCI safe and effective for STEMI patients during the COVID-19 pandemic when using recommended safety measures?
Primary PCI can be safely continued as the main reperfusion strategy for STEMI during the COVID-19 pandemic provided appropriate safety measures and PPE are utilized.
Supports primary PCI safety for STEMI during COVID-19; hypothesis-generating and requires prospective validation before practice change.
BACKGROUND: In the Coronavirus Disease 2019 (COVID-19) pandemic, the appropriate reperfusion strategy in patients with ST-segment elevation myocardial infarction (STEMI) is unclear. METHODS: This retrospective single-center study consecutively enrolled patients who presented with STEMI and scheduled for primary percutaneous coronary intervention (PPCI) during the outbreak of COVID-19. Due to the delay in the reporting of the polymerase chain reaction test results, our postprocedural triage regarding COVID-19, followed by the isolation strategy, was based on lung computerized tomography scan results. RESULTS: Forty-eight patients with STEMI referred to our center. PPCI was done for 44 (91%) of these patients. The mean symptom-to-device time was 490.93 ± 454.608 minutes, and the mean first medical contact-to-device time was and 154.12 ± 36.27 minutes. Nine (18%) patients with STEMI were diagnosed as having typical/indeterminate features indicating COVID-19 involvement. During hospitalization, 1 (2.0%) patient died of cardiogenic shock. The study population was followed for 35.9 ± 12.7 days. Two patients expired in another centers due to COVID-19. No cardiac catheterization laboratory staff members were infected by COVID-19 during the study period. CONCLUSIONS: Our small report indicates that by taking the recommended safety measures and using appropriate PPE, we can continue PPCI as the main reperfusion strategy safely and effectively.
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Firouzi et al. (2020) conducted an observational in ST-elevation Myocardial Infarction (STEMI) (n=48). Primary percutaneous coronary intervention (PPCI) was evaluated on In-hospital mortality. Primary percutaneous coronary intervention was safely performed in STEMI patients during the COVID-19 outbreak, with a 2.0% in-hospital mortality rate and no staff infections.
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