Gender Difference in the Effects of COVID-19 Pandemic on Mechanical Reperfusion and 30-Day Mortality for STEMI: Results of the ISACS-STEMI COVID-19 Registry.

Fecha de publicación: 23/01/2023 Fecha Ahead of Print: 23/01/2023

Autores de IIS La Fe

José Luis Díez Gil

Autor

Participantes ajenos a IIS La Fe

De Luca, Giuseppe
Manzo-Silberman, Stephane
Algowhary, Magdy
Uguz, Berat
Oliveira, Dinaldo C.
Ganyukov, Vladimir
Busljetik, Oliver
Cercek, Miha
Okkels, Lisette
Loh, Poay Huan
Calmac, Lucian
Ferrer, Gerard Roura I
Quadros, Alexandre
Milewski, Marek
Scotto di Uccio, Fortunato
von Birgelen, Clemens
Versaci, Francesco
Ten Berg, Jurrien
Casella, Gianni
Wong Sung Lung, Aaron
Kala, Petr
Carrillo, Xavier
Dirksen, Maurits
Becerra, 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, Jose
Flavien, Vincent
Fabris, Enrico
Martinez-Luengas, Inigo Lozano
Boccalatte, Marco
Ojeda, Francisco Bosa
Arellano-Serrano, Carlos
Caiazzo, Gianluca
Cirrincione, Giuseppe
Kao, Hsien-Li
Fores, Juan Sanchis
Vignali, Luigi
Pereira, Helder
Ordonez, Santiago
Arat Ozkan, Alev
Scheller, Bruno
Lehtola, Heidi
Teles, Rui
Mantis, Christos
Antti, Ylitalo
Brum Silveira, Joao Antonio
Zoni, Cesar Rodrigo
Bessonov, Ivan
Uccello, Giuseppe
Kochiadakis, George
Alexopulos, Dimitrios
Uribe, Carlos E.
Kanakakis, John
Faurie, Benjamin
Gabrielli, Gabriele
Barrios, Alejandro Gutierrez
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
Bouraghda, Mohamed Abed
Moura, Marcia
Kedhi, Elvin
Lamelas, Pablo
Suryapranata, Harry
Nardin, Matteo
Verdoia, Monica

Grupos

Grupo de Investigación Clínica y Traslacional en Cardiología

Investigador Principal

Esther Roselló Lletí

Abstract

BACKGROUND: Several reports have demonstrated the impact of the COVID-19 pandemic on the management and outcome of patients with ST-segment elevation myocardial infarction (STEMI). The aim of the current analysis is to investigate the potential gender difference in the effects of the COVID-19 pandemic on mechanical reperfusion and 30-day mortality for STEMI patients within the ISACS-STEMI COVID-19 Registry. METHODS: This retrospective multicenter registry was performed in high-volume primary percutaneous coronary intervention (PPCI) centers on four continents and included STEMI patients undergoing PPCIs in March-June 2019 and 2020. Patients were divided according to gender. The main outcomes were the incidence and timing of the PPCI, (ischemia time = 12 h and door-to-balloon = 30 min) and in-hospital or 30-day mortality. RESULTS: We included 16683 STEMI patients undergoing PPCIs in 109 centers. In 2020 during the pandemic, there was a significant reduction in PPCIs compared to 2019 (IRR 0.843 (95% CI: 0.825-0.861, p < 0.0001). We did not find a significant gender difference in the effects of the COVID-19 pandemic on the numbers of STEMI patients, which were similarly reduced from 2019 to 2020 in both groups, or in the mortality rates. Compared to prepandemia, 30-day mortality was significantly higher during the pandemic period among female (12.1% vs. 8.7%; adjusted HR [95% CI] = 1.66 [1.31-2.11], p < 0.001) but not male patients (5.8% vs. 6.7%; adjusted HR [95% CI] = 1.14 [0.96-1.34], p = 0.12). CONCLUSIONS: The COVID-19 pandemic had a significant impact on the treatment of patients with STEMI, with a 16% reduction in PPCI procedures similarly observed in both genders. Furthermore, we observed significantly increased in-hospital and 30-day mortality rates during the pandemic only among females. Trial registration number: NCT 04412655.