Who Has Seen Patients With ST-Segment-Elevation Myocardial Infarction? First Results From Italian Real-World Coronavirus Disease 2019.
Who Has Seen Patients With ST-Segment-Elevation Myocardial Infarction? First Results From Italian Real-World Coronavirus Disease 2019.
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DOI：
10.1161/jaha.120.017126
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发表时间：
2020-10-20
影响因子：
5.4
通讯作者：
Romeo F
中科院分区：
文献类型：
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作者：
Cammalleri V;Muscoli S;Benedetto D;Stifano G;Macrini M;Di Landro A;Di Luozzo M;Marchei M;Mariano EG;Cota L;Sergi D;Bezzeccheri A;Bonanni M;Baluci M;De Vico P;Romeo F
2019冠状病毒病爆发后，为控制感染，采取了社会隔离措施。虽然目前感染的速度有所减缓，但住院治疗的减少，特别是心肌梗死的住院治疗。本研究的目的是通过分析近期接受经皮冠状动脉介入治疗的患者病例，评估2019冠状病毒病大流行期间感染性疾病对ST段抬高型心肌梗死（STEMI）护理的影响。收集2020年3月1日至31日意大利政府社会限制期间的连续STEMI患者，并与2019年3月期间治疗的STEMI患者进行比较。在2020年3月，我们观察到与2019年同期相比，入院的STEMI患者减少了63%（13例对35例）。值得注意的是，STEMI护理的所有时间组成部分都发生了变化，特别是症状到首次医疗接触、轮辐到轮毂和累积症状到导线延迟的中位时间更长。两组患者的手术数据和住院结果相似，而2020年患者的住院时间更长。在该组中，我们还观察到在基线和出院时心脏生物标志物水平较高，左心室射血分数较差。2019年冠状病毒病的爆发导致STEMI患者入院人数减少，治疗延误增加，住院时间延长，心脏生物标志物水平升高，左心室功能恶化。
After the coronavirus disease 2019 outbreak, social isolation measures were introduced to contain infection. Although there is currently a slowing down of the infection, a reduction of hospitalizations, especially for myocardial infarction, was observed. The aim of our study is to evaluate the impact of the infectious disease on ST‐segment–elevation myocardial infarction (STEMI) care during the coronavirus disease 2019 pandemic, through the analysis of recent cases of patients who underwent percutaneous coronary intervention. Consecutive patients affected by STEMI from March 1 to 31, 2020, during social restrictions of Italian government, were collected and compared with patients with STEMI treated during March 2019. During March 2020, we observed a 63% reduction of patients with STEMI who were admitted to our catheterization laboratory, when compared with the same period of 2019 (13 versus 35 patients). Changes in all time components of STEMI care were notably observed, particularly for longer median time in symptom‐to‐first medical contact, spoke‐to‐hub, and the cumulative symptom‐to‐wire delay. Procedural data and in‐hospital outcomes were similar between the 2 groups, whereas the length of hospitalization was longer in patients of 2020. In this group, we also observed higher levels of cardiac biomarkers and a worse left ventricular ejection fraction at baseline and discharge. The coronavirus disease 2019 outbreak induced a reduction of hospital access for STEMI with an increase in treatment delay, longer hospitalization, higher levels of cardiac biomarkers, and worse left ventricular function.