RT Journal Article
T1 Impact of COVID-19 pandemic and diabetes on mechanical reperfusion in patients with STEMI: insights from the ISACS STEMI COVID 19 Registry
A1 De Luca, Giuseppe
A1 Cercek, Miha
A1 Jensen, Lisette Okkels
A1 Vavlukis, Marija
A1 Calmac, Lucian
A1 Johnson, Tom
A1 Roura I Ferrer, Gerard
A1 Ganyukov, Vladimir
A1 Wojakowski, Wojtek
A1 von Birgelen, Clemens
A1 Versaci, Francesco
A1 Ten Berg, Jurrien
A1 Laine, Mika
A1 Dirksen, Maurits
A1 Casella, Gianni
A1 Kala, Petr
A1 Díez Gil, José Luis
A1 Becerra, Victor
A1 De Simone, Ciro
A1 Carrill, Xavier
A1 Scoccia, Alessandra
A1 Lux, Arpad
A1 Kovarnik, Tomas
A1 Davlouros, Periklis
A1 Gabrielli, Gabriele
A1 Flores Rios, Xacobe
A1 Bakraceski, Nikola
A1 Levesque, Sébastien
A1 Guiducci, Vincenzo
A1 Kidawa, Michał
A1 Marinucci, Lucia
A1 Zilio, Filippo
A1 Galasso, Gennaro
A1 Fabris, Enrico
A1 Menichelli, Maurizio
A1 Manzo, Stephane
A1 Caiazzo, Gianluca
A1 Moreu, Jose
A1 Sanchis Forés, Juan
A1 Donazzan, Luca
A1 Vignali, Luigi
A1 Teles, Rui
A1 Bosa Ojeda, Francisco
A1 Lehtola, Heidi
A1 Camacho-Freiere, Santiago
A1 Kraaijeveld, Adriaan
A1 Antti, Ylitalo
A1 Boccalatte, Marco
A1 Martínez-Luengas, Iñigo Lozano
A1 Scheller, Bruno
A1 Alexopoulos, Dimitrios
A1 Uccello, Giuseppe
A1 Faurie, Benjamin
A1 Gutierrez Barrios, Alejandro
A1 Wilbert, Bor
A1 Cortese, Giuliana
A1 Moreno, Raul
A1 Parodi, Guido
A1 Kedhi, Elvin
A1 Verdoia, Monica
K1 COVID-19
K1 Diabetes mellitus
K1 Reperfusion
K1 ST elevation myocardial infarction
K1 Percutaneous coronary intervention
K1 Acute coronary syndrome
K1 Pandemic
K1 Infarto del miocardio con elevación del ST
K1 Intervención coronaria percutánea
K1 Síndrome coronario agudo
K1 Pandemia
AB Background: It has been suggested the COVID pandemic may have indirectly affected the treatment and outcome of STEMI patients, by avoidance or significant delays in contacting the emergency system. No data have been reported on the impact of diabetes on treatment and outcome of STEMI patients, that was therefore the aim of the current subanalysis conducted in patients included in the International Study on Acute Coronary Syndromes-ST Elevation Myocardial Infarction (ISACS-STEMI) COVID-19.Methods: The ISACS-STEMI COVID-19 is a retrospective registry performed in European centers with an annual volume of > 120 primary percutaneous coronary intervention (PCI) and assessed STEMI patients, treated with primary PCI during the same periods of the years 2019 versus 2020 (March and April). Main outcomes are the incidences of primary PCI, delayed treatment, and in-hospital mortality.Results: A total of 6609 patients underwent primary PCI in 77 centers, located in 18 countries. Diabetes was observed in a total of 1356 patients (20.5%), with similar proportion between 2019 and 2020. During the pandemic, there was a significant reduction in primary PCI as compared to 2019, similar in both patients with (Incidence rate ratio (IRR) 0.79 (95% CI: 0.73-0.85, p < 0.0001) and without diabetes (IRR 0.81 (95% CI: 0.78-0.85, p < 0.0001) (p int = 0.40). We observed a significant heterogeneity among centers in the population with and without diabetes (p < 0.001, respectively). The heterogeneity among centers was not related to the incidence of death due to COVID-19 in both groups of patients. Interaction was observed for Hypertension (p = 0.024) only in absence of diabetes. Furthermore, the pandemic was independently associated with a significant increase in door-to-balloon and total ischemia times only among patients without diabetes, which may have contributed to the higher mortality, during the pandemic, observed in this group of patients.Conclusions: The COVID-19 pandemic had a significant impact on the treatment of patients with STEMI, with a similar reduction in primary PCI procedures in both patients with and without diabetes. Hypertension had a significant impact on PCI reduction only among patients without diabetes. We observed a significant increase in ischemia time and door-to-balloon time mainly in absence of diabetes, that contributed to explain the increased mortality observed in this group of patients during the pandemic.
PB BioMed Central
YR 2020
FD 2020-12-18
LK http://hdl.handle.net/10668/3423
UL http://hdl.handle.net/10668/3423
LA en
NO De Luca G, Cercek M, Jensen LO, Vavlukis M, Calmac L, Johnson T, et al. Impact of COVID-19 pandemic and diabetes on mechanical reperfusion in patients with STEMI: insights from the ISACS STEMI COVID 19 Registry. Cardiovasc Diabetol. 2020 Dec 18;19(1):215.
DS RISalud
RD Apr 17, 2025