1. Impact in total ischemic time and ST-segment elevation myocardial infarction admissions during COVID-19
- Author
-
Chaim Yosefy, Yaniv Sherer, Jamal Jafari, Nasi Viki, Azriel Osherov, Sharon Bruoha, Jonathan Rieck, Enrique Gallego-Colon, Yan Orlov, and Abu Hamed Jihad
- Subjects
Male ,Acute coronary syndrome ,medicine.medical_specialty ,medicine.medical_treatment ,Ischemia time ,SARS-Cov ,Disease ,Comorbidity ,Care ,Revascularization ,Article ,Time-to-Treatment ,STEMI ,03 medical and health sciences ,0302 clinical medicine ,Percutaneous Coronary Intervention ,Pandemic ,medicine ,ST segment ,Humans ,Myocardial infarction ,Time-to-balloon ,Israel ,Pandemics ,Reperfusion strategies ,Primary PCI ,Cause of death ,business.industry ,SARS-CoV-2 ,COVID-19 ,030208 emergency & critical care medicine ,General Medicine ,Middle Aged ,medicine.disease ,Triage ,Management ,Hospitalization ,Emergency medicine ,Emergency Medicine ,ST Elevation Myocardial Infarction ,Female ,business - Abstract
Background Despite the COVID-19 pandemic, cardiovascular disease is still the main cause of death in developed countries. Of these deaths, acute coronary syndromes (ACS) account for a substantial percentage of deaths. Improvement in ACS outcomes, are achieved by reducing the time from symptom onset until reperfusion or total ischemic time (TIT). Nevertheless, due to the overwhelming reality at the beginning of the pandemic, acute coronary syndrome (ACS) care may have been compromised. Objectives We evaluated delays in TIT based on the date and timing of admissions in patients with STEMI, by a timeline follow-up form, before and during the current COVID-19 pandemic. Methods Between July 2018 and June 2020, two hundred and twelve patients diagnosed with ST-segment elevation myocardial infarction (STEMI) were admitted to our medical center. Upon presentation, cases were assigned a timeline report sheet and each time interval, from onset of symptoms to the catheterization lab, was documented. The information was later evaluated to study potential excessive delays throughout ACS management. Results Our data evidenced that during the COVID-19 pandemic ACS admissions were reduced by 34.54%, in addition to several in-hospital delays in patient's ACS management including delays in door-to-ECG time (9.43 ± 18.21 vs. 18.41 ± 28.34, p = 0.029), ECG-to-balloon (58.25 ± 22.59 vs. 74.39 ± 50.30, p = 0.004) and door-to-balloon time (57.41 ± 27.52 vs. 69.31 ± 54.14, p = 0.04). Conclusions During the pandemic a reduction in ACS admissions occurred in our hospital that accompanied with longer in-hospital TIT due to additional tests, triage, protocols to protect and prevent infection within hospital staff, and maintenance of adequate standards of care. However, door-to-balloon time was maintained under 90 min.
- Published
- 2021