Mechanical complications in ST-elevation myocardial infarction: The impact of pre-hospital delay

Bouisset, Frédéric; Deney, Antoine; Ferrières, Jean; Panagides, Vassili; Becker, Mathieu; Rivière, Nicolas; Yvorel, Cédric; Commeau, Philippe; Adjedj, Julien; Benamer, Hakim; Bonnet, Guillaume; Cayla, Guillaume

doi:10.1016/j.ijcard.2021.10.020

Cited by 15 publications

(13 citation statements)

References 22 publications

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“…Mechanical complications in the PCI era has a low incidence (0.3–1%) ( 7 , 11 ). Bouisset et al ( 12 ) recently showed an increased MC in STEMI patients admitted during the pandemic, related to pre-hospital delay in the last 6 months in France (1.3%). The delay between symptoms onset and first medical contact was significantly longer among patients with MC: 801 [210–3406] vs. 135 [60–369] min.…”

Section: Discussionmentioning

confidence: 98%

Outcomes and mechanical complications of acute myocardial infarction during the second wave pandemic in a Milan HUB center for cardiac emergencies

Penso

Frappampina

Cosentino

et al. 2022

Front. Cardiovasc. Med.

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AimsCOVID-19 has dramatically impacted the healthcare system. Evidence from previous studies suggests a decline in in-hospital admissions for acute myocardial infarction (AMI) during the pandemic. However, the effect of the pandemic on mechanical complications (MC) in acute ST-segment elevation myocardial infarction (STEMI) has not been comprehensively investigated. Therefore, we evaluated the impact of the pandemic on MC and in-hospital outcomes in STEMI during the second wave, in which there was a huge SARS-CoV-2 diffusion in Italy.Methods and resultsBased on a single center cohort of AMI patients admitted with STEMI between February 1, 2019, and February 28, 2021, we compared the characteristics and outcomes of STEMI patients treated during the pandemic vs. those treated before the pandemic. In total, 479 STEMI patients were included, of which 64.5% were during the pandemic. Relative to before the pandemic, primary percutaneous coronary intervention (PCI) declined (87.7 vs. 94.7%, p = 0.014) during the pandemic. Compared to those admitted before the pandemic (10/2019 to 2/2020), STEMI patients admitted during the second wave (10/2020 to 2/2021) presented with a symptom onset-to-door time greater than 24 h (26.1 vs. 10.3%, p = 0.009) and a reduction of primary PCI (85.2 vs. 97.1%, p = 0.009). MC occurred more often in patients admitted during the second wave of the pandemic than in those admitted before the pandemic (7.0 vs. 0.0%, p = 0.032). In-hospital mortality increased during the second wave (10.6 vs. 2.9%, p = 0.058).ConclusionAlthough the experience gained during the first wave and a more advanced hub-and-spoke system for cardiovascular emergencies persists, late hospitalizations and a high incidence of mechanical complications in STEMI were observed even in the second wave.

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Section: Discussionmentioning

confidence: 98%

Outcomes and mechanical complications of acute myocardial infarction during the second wave pandemic in a Milan HUB center for cardiac emergencies

Penso

Frappampina

Cosentino

et al. 2022

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

show abstract

“…A manifestation of this phenomenon was that the rate of mechanical complication amounted to 0.82% for the time period 0–12 h, 1.435 for the period 12–24 h, 1.24% for the time period 24–36 h, and 5.07% during the time period 36–48 h.. A similar trend was noted for VSR although, in that specific instance, it did not reach statistical significance. Furthermore, in that review, the mortality rate for VSR was as high as 54.6% [ 3 ]. A comparable trend was demonstrated by data from another institution, whereby, with the onset of the COVID-19 pandemic, the average number of operations for VSR increased to 4 cases/year, having been as low as 1.9 cases/year in previous years [ 4 ].…”

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confidence: 99%

A new dimension to the STEMI-related mortality risk seen in the COVID-19 pandemic era

Jolobe¹

2022

The American Journal of Emergency Medicine

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“…In this issue of the International Journal of Cardiology, Bouisset et al investigated the incidence and outcome of MC according to pre-hospital delay and their determinants [2], based on a large registry [3]. The study included 6,185 STEMI patients, which were included in 65 French interventional cardiology centers over two periods (each March to May) in 2019 and 2020.…”

mentioning

confidence: 99%

Mechanical complications after STEMI: Another collateral damage of the COVID-19 pandemic

Holzknecht

Klug

Metzler

et al. 2022

International Journal of Cardiology

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Mechanical complications in ST-elevation myocardial infarction: The impact of pre-hospital delay

Cited by 15 publications

References 22 publications

Outcomes and mechanical complications of acute myocardial infarction during the second wave pandemic in a Milan HUB center for cardiac emergencies

Outcomes and mechanical complications of acute myocardial infarction during the second wave pandemic in a Milan HUB center for cardiac emergencies

A new dimension to the STEMI-related mortality risk seen in the COVID-19 pandemic era

Mechanical complications after STEMI: Another collateral damage of the COVID-19 pandemic

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