학술논문
Age-Related Effects of COVID-19 Pandemic on Mechanical Reperfusion and 30-Day Mortality for STEMI: Results of the ISACS-STEMI COVID-19 Registry
Document Type
article
Author
Giuseppe De Luca; Magdy Algowhary; Berat Uguz; Dinaldo C. Oliveira; Vladimir Ganyukov; Oliver Busljetik; Miha Cercek; Lisette Okkels Jensen; Poay Huan Loh; Lucian Calmac; Gerard Roura i Ferrer; Alexandre Quadros; Marek Milewski; Fortunato Scotto D’Uccio; Clemens von Birgelen; Francesco Versaci; Jurrien Ten Berg; Gianni Casella; Aaron Wong Sung Lung; Petr Kala; José Luis Díez Gil; Xavier Carrillo; Maurits Dirksen; Victor Becerra Munoz; Michael Kang-yin Lee; Dafsah Arifa Juzar; Rodrigo de Moura Joaquim; Roberto Paladino; Davor Milicic; Periklis Davlouros; Nikola Bakraceski; Filippo Zilio; Luca Donazzan; Adriaan Kraaijeveld; Gennaro Galasso; Lux Arpad; Lucia Marinucci; Vincenzo Guiducci; Maurizio Menichelli; Alessandra Scoccia; Aylin Hatice Yamac; Kadir Ugur Mert; Xacobe Flores Rios; Tomas Kovarnik; Michal Kidawa; Josè Moreu; Vincent Flavien; Enrico Fabris; Iñigo Lozano Martínez-Luengas; Marco Boccalatte; Francisco Bosa Ojeda; Carlos Arellano-Serrano; Gianluca Caiazzo; Giuseppe Cirrincione; Hsien-Li Kao; Juan Sanchis Forés; Luigi Vignali; Helder Pereira; Stephane Manzo-Silberman; Santiago Ordoñez; Alev Arat Özkan; Bruno Scheller; Heidi Lehitola; Rui Teles; Christos Mantis; Ylitalo Antti; João António Brum Silveira; Cesar Rodrigo Zoni; Ivan Bessonov; Giuseppe Uccello; George Kochiadakis; Dimitrios Alexopulos; Carlos E. Uribe; John Kanakakis; Benjamin Faurie; Gabriele Gabrielli; Alejandro Gutierrez Barrios; Juan Pablo Bachini; Alex Rocha; Frankie C. C. Tam; Alfredo Rodriguez; Antonia Anna Lukito; Veauthyelau Saint-Joy; Gustavo Pessah; Andrea Tuccillo; Alfonso Ielasi; Giuliana Cortese; Guido Parodi; Mohammed Abed Burgadha; Elvin Kedhi; Pablo Lamelas; Harry Suryapranata; Matteo Nardin; Monica Verdoia
Source
Journal of Clinical Medicine, Vol 12, Iss 6, p 2116 (2023)
Subject
Language
English
ISSN
2077-0383
Abstract
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.