Treatment delay and outcomes of ST-segment elevation myocardial infarction treated by primary percutaneous coronary intervention during the COVID-19 era in South Korea

Oh, Seok; Cho, Jeong Gwan; Cho, Kyung Hoon; Kim, Min Chul; Sim, Doo Sun; Hong, Young Joon; Kim, Ju Han; Ahn, Youngkeun

doi:10.3904/kjim.2022.077

Cited by 1 publication

(2 citation statements)

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“…An interesting point to discuss is that although admissions for STEMI seemed to decrease, STEMI cases presented with worse clinical manifestations and outcomes [7][8][9]32]. This could be attributed to delayed patients' admission (possibly due to the fear of transmission) [7,8] or to virus-related pathophysiological pathways (inflammation, prothrombotic condition [33]), leading to more severe disease (large coronary thrombus burden has been noted in most COVID-19 patients suffering STEMI [34]). COVID-19 infection represents a prothrombotic condition affecting both the venous and arterial system [35][36][37][38][39].…”

Section: Discussionmentioning

confidence: 99%

“…This trend though should be interpreted with caution as it cannot be necessarily translated to absolute decrease of STEMI cases, but perhaps implies a delayed or hesitant admission of STEMI patients due to fear of COVID-19 transmission, with a subsequent increase of out-of-hospital cardiac arrest events [ 6 ]. Interestingly, STEMI cases presented a significant delay to hospital admission and management (symptom-to-call and call-to-balloon times) as well as higher troponin levels and worse prognosis compared to STEMI cases before the pandemic [ 7 , 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

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ST-Segment Elevation Myocardial Infarction (STEMI) Management in the Era of COVID-19: A Systematic and Critical Review of Published Guidance Reports

Kyriakoulis¹,

Trontzas²,

Kyriakoulis³

et al. 2023

Rev. Cardiovasc. Med.

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Background: Coronavirus disease 2019 (COVID-19) had a major impact on healthcare systems worldwide. During the early phase of the pandemic many elective procedures were postponed. At the same time, the safe and effective management of medical emergencies such as ST-segment elevation myocardial infarction (STEMI) has been a challenge. Methods: A systematic literature search was conducted aiming to identify published guidance reports by national or international societies regarding the management of patients suffering STEMI in the era of COVID-19. Results: Among 1681 articles initially retrieved, six fulfilled the inclusion criteria and were included in the systematic review. Two reports were international consensus documents, while four reports were national guidance statements from Asian countries (Taiwan, India, Iran, and China). Most documents were drafted during the early phase of the pandemic. According to the international consensus documents, percutaneous coronary intervention (PCI) should be regarded as the reperfusion method of choice. On the other hand, in three out of four national consensus statements (Taiwan, Iran and China) fibrinolysis was considered as the reperfusion method of choice for STEMI in suspected/confirmed patients with COVID-19, unless contraindicated or in the presence of high cardiovascular risk clinical features. Authors of all documents underlined the need for early COVID-19 testing in patients with STEMI to better determine the next therapeutical steps. Conclusions: National and international consensus statements for STEMI management in the era of COVID-19 have been published mainly during the early peak phase of the pandemic. Authors recognise that these recommendations are mainly based on expert opinions and observational data. As global immunization rates increase and methods for rapid COVID-19 detection are widely available, the implementation of traditional evidence-based practices used before the pandemic is becoming more feasible.

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