The SARS-CoV-2 pandemic significantly increased total ischemia time (326 vs 304 min, p<0.001) and patient delay (105 vs 90 min, p=0.002) for STEMI patients undergoing primary PCI.
Cohort (n=1,962)
No
Did the SARS-CoV-2 pandemic increase treatment delays and total ischemia time in STEMI patients undergoing primary PCI?
The COVID-19 pandemic significantly increased total ischemia time and patient delays for STEMI patients undergoing primary PCI.
Absolute Event Rate: 326% vs 304%
p-value: p=<0.001
Abstract Introduction Ischemic heart disease stands as the predominant cause of mortality. The mortality rate among individuals experiencing an acute coronary syndrome with ST-elevation (STEMI) is influenced by various factors, including the time lapse before treatment, encompassing percutaneous primary angioplasty (PPCI) or fibrinolysis. To enhance the quality of care, it is essential to systematically document and assess treatment delays. The COVID-19 pandemic had a profound impact on healthcare systems worldwide. We aim to analyse the impact of SARS-CoV-2 pandemic in times and delays in the emergent coronary referral pathway in our region. Methods and Results We studied consecutive STEMI patients from 2013 to 2022, admitted in our centre for primary percutaneous coronary angioplasty (PPCI). We defined pandemic period as the interval between 2020 and 2022. Time variables included were: patient delay, electrocardiogram (ECG) delay, diagnostic delay, logistic delay, transport delay, home delay, procedure time. With these variables we also registered: first medical contact (FMC) to diagnosis time, door-in-door out time, door to wire, diagnosis to wire, FMC to wire and total ischemia time. We included a total of 1962 PCI cases, with a median patient age of 64 ±14 years and with 74% being males. We found that median patient delay was higher during the SARS-CoV-2 pandemic (90min vs 105min, p=0,002) and that the median transport time during the same period was also higher (55min vs 62min, p0,001). Home delay was lower during the pandemic interval (18min vs 12min, p0,001). In contrast, procedure time was higher in SARS-CoV-2 period (27min vs 32min, p0,001) and we verified the same considering total ischemia time (304min vs 326min,p0,001). Conclusion The COVID-19 pandemic had a profound impact on healthcare systems worldwide and our centre was not an exception. As expected, patient delay was higher during the pandemic period reflecting the fear of looking for health care during this time. Importantly, our analysis show that the home delay was lower during pandemic, so we must maintain and improve the strategies adopted as a new foundation, so we can provide the best quality of care possible to our population.
Viana et al. (Fri,) conducted a cohort in STEMI (n=1,962). SARS-CoV-2 pandemic period vs. Pre-pandemic period was evaluated on Total ischemia time (minutes) (p=<0.001). The SARS-CoV-2 pandemic significantly increased total ischemia time (326 vs 304 min, p<0.001) and patient delay (105 vs 90 min, p=0.002) for STEMI patients undergoing primary PCI.