An international survey in Latin America on the practice of interventional cardiology during the COVID-19 pandemic, with a particular focus on myocardial infarction

Abstract

Introduction A reduction in the number of interventional cardiology procedures has emerged as a result of the COVID-19 pandemic. A survey was performed to quantify this decrease and the impact on the management of myocardial infarction in Latin America. Methods A telematic survey was conducted for all countries in Latin America. Diagnostic catheterisations, coronary and structural interventions, as well as the incidence and delay to reperfusion therapy of myocardial infarction (STEMI), were recorded. Two periods were compared: from 24 February to 8 March 2020 (pre-COVID-19) and another 2‑week period that varied according to country (COVID-19). Results Responses were obtained from 79 centres in 20 countries. There was a significant decrease in the number of diagnostic procedures (−65.2%), coronary interventions (−59.4%), structural therapeutics (−86.1%) and STEMI care (−51.2%). A decrease was noted in the incidence of STEMI, but also a delay in the time to STEMI reperfusion. While there was a variation in activity in interventional cardiology between countries, patient behaviour was rather homogeneous. Conclusions A significant reduction in healthcare activity has been noted during the COVID-19 pandemic, including STEMI care, with the risk of increased mortality and/or morbidity following STEMI. Healthcare providers should encourage patients with suspected symptoms of STEMI to call for emergency care to ensure rapid diagnosis and timely reperfusion treatment.

Encuesta latinoamericana sobre el grado de variación de la actividad asistencial en los Servicios de Cardiología Intervencionista por la pandemia COVID-19. Subanálisis de la situación de Uruguay

“…Esto resulta llamativo, dado que sería previsible una disminución de los procedimientos coordinados y no en los SCA. Esto concuerda con estudios internacionales recientemente publicados (4,6) . Un estudio realizado en un hospital en Hong Kong mostró que después de iniciadas las medidas de control de infección hubo un gran aumento de los tiempos desde el inicio de los síntomas hasta el primer contacto médico en pacientes con IAMceST y retrasos en la evaluación e ingreso del paciente al laboratorio de hemodinamia (5) .…”

“…El análisis preliminar mostró una reducción de 38% de la activación del código infarto (7) . En la encuesta Latinoamericana realizada por Mayol y colaboradores en la que se obtuvo respuesta de 79 centros en 20 países, hubo una disminución significativa en el número de procedimientos de diagnóstico (65,2%), intervenciones coronarias (59,4%), terapéutica estructural (86,1%) y atención en IAMceST (51,2%) (4) . Como era previsible, los procedimientos de coordinación fueron los que más disminuyeron en forma proporcional.…”

“…Se realizó un estudio transversal y descriptivo a través de una encuesta de opinión para evaluar la actividad en los centros de hemodinamia de América Latina en una quincena previa y en otra posterior a la declaración de la cuarentena o el confinamiento social en cada país por la pandemia COVID-19 (4) . Para Uruguay el periodo pre COVID-19 se estableció desde el lunes 24 de febrero al domingo 8 de marzo de 2020 y el periodo COVID-19, desde el lunes 23 de marzo al domingo 5 de abril.…”

The Impact of the COVID-19 Pandemic and the Importance of Telemedicine in Managing Acute ST Segment Elevation Myocardial Infarction Patients: Preliminary Experience and Literature Review

“…A reduction in total numbers of STEMI patients who underwent primary percutaneous coronary intervention (PCI) also was observed in several studies. Mayol J et al reported a 51.2% reduction in PCI for STEMI patients in Latin America during the pandemic [ 25 ]. Garcia S, et al estimated that STEMI patients who underwent primary PCI decreased by approximately 38% in the United States of America during the COVID-19 pandemic [ 26 ].…”

The Netherlands Heart Journal: special issue on COVID-19

“…COVID-19 has had a huge impact on cardiac care in recent months, and the article of Mayol et al. [ 7 ] delivers undeniable evidence of this. The authors describe the results from a telematic survey for all Latin American countries, showing a significant reduction in cardiac care activity during the COVID-19 pandemic, including a significant reduction in care for ST-elevation myocardial infarction (STEMI).…”