Age-Related 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: 08/03/2023 Fecha Ahead of Print: 08/03/2023

Autores de IIS La Fe

José Luis Díez Gil

Autor

Participantes ajenos a IIS La Fe

De Luca, Giuseppe
Algowhary, Magdy
Uguz, Berat
Oliveira, Dinaldo C.
Ganyukov, Vladimir
Busljetik, Oliver
Cercek, Miha
Jensen, Lisette Okkels
Loh, Poay Huan
Calmac, Lucian
Ferrer, Gerard Roura i
Quadros, Alexandre
Milewski, Marek
Scotto D'Uccio, Fortunato
von Birgelen, Clemens
Versaci, Francesco
Ten Berg, Jurrien
Casella, Gianni
Wong Sung Lung, Aaron
Kala, Petr
Carrillo, Xavier
Dirksen, Maurits
Becerra Munoz, 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
Bosa Ojeda, Francisco
Arellano-Serrano, Carlos
Caiazzo, Gianluca
Cirrincione, Giuseppe
Kao, Hsien-Li
Sanchis Fores, Juan
Vignali, Luigi
Pereira, Helder
Manzo-Silberman, Stephane
Ordonez, Santiago
Arat Ozkan, Alev
Scheller, Bruno
Lehitola, 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
Gutierrez Barrios, Alejandro
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
Burgadha, Mohammed Abed
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: 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.