Impact of COVID-19 pandemic on STEMI undergoing primary PCI treatment in Beijing, China

Xuhe Gong; Li Zhou; Tianhui Dong; Xiaosong Ding; Huiqiang Zhao; Hui Chen; Hongwei Li

doi:10.1016/j.ajem.2021.11.034

Impact of COVID-19 pandemic on STEMI undergoing primary PCI treatment in Beijing, China

Am J Emerg Med. 2022 Mar:53:68-72. doi: 10.1016/j.ajem.2021.11.034. Epub 2021 Nov 24.

Authors

Xuhe Gong¹, Li Zhou¹, Tianhui Dong¹, Xiaosong Ding¹, Huiqiang Zhao¹, Hui Chen¹, Hongwei Li²

Affiliations

¹ Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, PR China.
² Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, PR China; Department of Internal Medicine, Medical Health Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, PR China; Beijing Key Laboratory of Metabolic Disorder Related Cardiovascular Disease, Beijing 100069, PR China. Electronic address: lhw19656@sina.com.

Abstract

Objective: Strict control measures under the COVID epidemic have brought an inevitable impact on ST-segment elevation myocardial infarction (STEMI)'s emergency treatment. We investigated the impact of the COVID on the treatment of patients with STEMI undergoing primary PCI.

Methods: In this single center cohort study, we selected a time frame of 6 month after declaration of COVID-19 infection (Jan 24-July 24, 2020); a group of STEMI patients in the same period of 2019 was used as control. Finally, a total of 246 STEMI patients, who were underwent primary PCI, were enrolled into the study (136 non COVID-19 outbreak periods and 110 COVID-19 outbreak periods). The impact of COVID on the time of symptom onset to the first medical contact (symptom-to-FMC) and door to balloon (D-to-B) was investigated. Moreover, the primary outcome was in-hospital major adverse cardiac events (MACE), defined as a composite of cardiac death, heart failure and malignant arrhythmia.

Results: Compared with the same period in 2019, there was a 19% decrease in the total number of STEMI patients undergoing primary PCI at the peak of the pandemic in 2020. The delay in symptom-to-FMC was significantly longer in COVID Outbreak period (180 [68.75, 342] vs 120 [60,240] min, P = 0.003), and the D-to-B times increased significantly (148 [115-190] vs 84 [70-120] min, P < 0.001). However, among patients with STEMI, MACE was similar in both time periods (18.3% vs 25.7%, p = 0.168). On multivariable analysis, COVID was not independently associated with MACE; the history of diabetes, left main disease and age>65 years were the strongest predictors of MACE in the overall population.

Conclusions: The COVID pandemic was not independently associated with MACE; suggesting that active primary PCI treatment preserved high-quality standards even when challenged by a severe epidemic.

Clinical trial registration: URL: https://ClinicalTrials.gov Unique identifier: NCT04427735.

Keywords: COVID-19; Door-to-balloon; MACE; Primary PCI; STEMI; Symptom-to-FMC.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Beijing / epidemiology
COVID-19 / complications
COVID-19 / prevention & control*
COVID-19 / transmission
Cohort Studies
Female
Humans
Male
Middle Aged
Percutaneous Coronary Intervention / statistics & numerical data*
Percutaneous Coronary Intervention / trends
Retrospective Studies
ST Elevation Myocardial Infarction / epidemiology
ST Elevation Myocardial Infarction / therapy*
Time Factors
Time-to-Treatment / standards
Time-to-Treatment / statistics & numerical data
Treatment Outcome

Associated data

ClinicalTrials.gov/NCT04427735