| Title: |
Age-Related Effects of COVID-19 Pandemic on Mechanical Reperfusion and 30-Day Mortality for STEMI:Results of the ISACS-STEMI COVID-19 Registry |
| Authors: |
De Luca,Giuseppe; Algowhary,Magdy; Uguz,Berat; Oliveira,Dinaldo C; Ganyukov,Vladimir; Busljetik,Oliver; Cercek,Miha; Jensen,Lisette Okkels; Loh,Poay Huan; Calmac,Lucian; Ferrer,Gerard Roura I; Quadros,Alexandre; Milewski,Marek; Scotto D'Uccio,Fortunato; von Birgelen,Clemens; Versaci,Francesco; Ten Berg,Jurrien; Casella,Gianni; Wong Sung Lung,Aaron; Kala,Petr; Díez Gil,José Luis; Carrillo,Xavier; Dirksen,Maurits; Becerra Munoz,Victor; Lee,Michael Kang-Yin; Juzar,Dafsah Arifa; de Moura Joaquim,Rodrigo; Paladino,Roberto; Milicic,Davor; Davlouros,Periklis; Bakraceski,Nikola; Zilio,Filippo; Donazzan,Luca; Kraaijeveld, Adriaan; Galasso,Gennaro; Arpad,Lux; Marinucci,Lucia; Guiducci,Vincenzo; Menichelli,Maurizio; Scoccia,Alessandra; Yamac,Aylin Hatice; Ugur Mert,Kadir; Flores Rios,Xacobe; Kovarnik,Tomas; Kidawa,Michal; Moreu,Josè; Flavien,Vincent; Fabris,Enrico; Martínez-Luengas,Iñigo Lozano; Boccalatte,Marco; Bosa Ojeda,Francisco; Arellano-Serrano,Carlos; Caiazzo,Gianluca; Cirrincione,Giuseppe; Kao,Hsien-Li; Sanchis Forés,Juan; Vignali,Luigi; Pereira,Helder; Manzo-Silberman,Stephane; Ordoñez,Santiago; Arat Özkan,Alev; Scheller,Bruno; Lehitola,Heidi; Teles,Rui; Mantis,Christos; Antti,Ylitalo; Brum Silveira,João António; Zoni,Cesar Rodrigo; Bessonov,Ivan; Uccello,Giuseppe; Kochiadakis,George; Alexopulos,Dimitrios; Uribe,Carlos E; Kanakakis,John; Faurie,Benjamin; Gabrielli,Gabriele; Gutierrez Barrios,Alejandro; Bachini,Juan Pablo; Rocha,Alex; Tam,Frankie C C; Rodriguez,Alfredo; Lukito,Antonia Anna; Saint-Joy,Veauthyelau; Pessah,Gustavo; Tuccillo,Andrea; Ielasi,Alfonso; Cortese,Giuliana; Parodi,Guido; Burgadha,Mohammed Abed; Kedhi,Elvin; Lamelas,Pablo; Suryapranata,Harry; Nardin,Matteo; Verdoia,Monica; Team Medisch; Circulatory Health |
| Publication Year: |
2023 |
| Subject Terms: |
COVID-19; ST-segment elevation myocardial infarction; ageing; General Medicine |
| Description: |
BACKGROUND: The constraints in the management of patients with ST-segment elevation myocardial infarction (STEMI) during the COVID-19 pandemic have been suggested to have severely impacted mortality levels. The aim of the current analysis is to evaluate the age-related effects of the COVID-19 pandemic on mechanical reperfusion and 30-day mortality for STEMI within the registry ISACS-STEMI COVID-19. METHODS: This retrospective multicenter registry was performed in high-volume PPCI centers on four continents and included STEMI patients undergoing PPCI in March-June 2019 and 2020. Patients were divided according to age (< or ≥75 years). The main outcomes were the incidence and timing of PPCI, (ischemia time longer than 12 h and door-to-balloon longer than 30 min), and in-hospital or 30-day mortality. RESULTS: We included 16,683 patients undergoing PPCI in 109 centers. In 2020, during the pandemic, there was a significant reduction in PPCI as compared to 2019 (IRR 0.843 (95%-CI: 0.825-0.861, p < 0.0001). We found a significant age-related reduction (7%, p = 0.015), with a larger effect on elderly than on younger patients. Furthermore, we observed significantly higher 30-day mortality during the pandemic period, especially among the elderly (13.6% vs. 17.9%, adjusted HR (95% CI) = 1.55 [1.24-1.93], p < 0.001) as compared to younger patients (4.8% vs. 5.7%; adjusted HR (95% CI) = 1.25 [1.05-1.49], p = 0.013), as a potential consequence of the significantly longer ischemia time observed during the pandemic. CONCLUSIONS: The COVID-19 pandemic had a significant impact on the treatment of patients with STEMI, with a 16% reduction in PPCI procedures, with a larger reduction and a longer delay to treatment among elderly patients, which may have contributed to increase in-hospital and 30-day mortality during the pandemic. |
| Document Type: |
article in journal/newspaper |
| File Description: |
text/plain |
| Language: |
English |
| ISSN: |
2077-0383 |
| Relation: |
https://dspace.library.uu.nl/handle/1874/448898 |
| Availability: |
https://dspace.library.uu.nl/handle/1874/448898 |
| Rights: |
info:eu-repo/semantics/OpenAccess |
| Accession Number: |
edsbas.D877808E |
| Database: |
BASE |