%0 Journal Article
%A Rodriguez-Leor, Oriol
%A Cid-Alvarez, Belen
%A Perez de Prado, Armando
%A Rossello, Xavier
%A Ojeda, Soledad
%A Serrador, Ana
%A Lopez-Palop, Ramon
%A Martin-Moreiras, Javier
%A Rumoroso, Jose Ramon
%A Cequier, Angel
%A Ibañez, Borja
%A Cruz-Gonzalez, Ignacio
%A Romaguera, Rafael
%A Moreno, Raul
%A Villa, Manuel
%A Ruiz-Salmeron, Rafael
%A Molano, Francisco
%A Sanchez, Carlos
%A Muñoz-García, Erika
%A Iñigo, Luis
%A Herrador, Juan
%A Gomez-Menchero, Antonio
%A Gomez-Menchero, Antonio
%A Caballero, Juan
%A Ojeda, Soledad
%A Cardenas, Mérida
%A Gheorghe, Livia
%A Oneto, Jesus
%A Morales, Francisco
%A Valencia, Felix
%A Ruiz, Jose Ramon
%A Diarte, Jose Antonio
%A Avanzas, Pablo
%A Rondan, Juan
%A Peral, Vicente
%A Pernasetti, Lucia Vera
%A Hernandez, Julio
%A Bosa, Francisco
%A Lorenzo, Pedro Luis Martin
%A Jimenez, Francisco
%A Hernandez, Jose M de la Torre
%A Jimenez-Mazuecos, Jesus
%A Lozano, Fernando
%A Moreu, Jose
%A Novo, Enrique
%A Robles, Javier
%A Moreiras, Javier Martin
%A Fernandez-Vazquez, Felipe
%A Amat-Santos, Ignacio J
%A Gomez-Hospital, Joan Antoni
%A Garcia-Picart, Joan
%A Blanco, Bruno Garcia Del
%A Regueiro, Ander
%A Carrillo-Suarez, Xavier
%A Tizon, Helena
%A Mohandes, Mohsen
%A Casanova, Juan
%A Agudelo-Montañez, Víctor
%A Muñoz, Juan Francisco
%A Franco, Juan
%A Del Castillo, Roberto
%A Salinas, Pablo
%A Elizaga, Jaime
%A Sarnago, Fernando
%A Jimenez-Valero, Santiago
%A Rivero, Fernando
%A Oteo, Juan Francisco
%A Alegria-Barrero, Eduardo
%A Sanchez-Recalde, Angel
%A Ruiz, Valeriano
%A Pinar, Eduardo
%A Pinar, Eduardo
%A Planas, Ana
%A Ledesma, Bernabe Lopez
%A Berenguer, Alberto
%A Fernandez-Cisnal, Agustin
%A Aguar, Pablo
%A Pomar, Francisco
%A Jerez, Miguel
%A Torres, Francisco
%A Garcia, Ricardo
%A Frutos, Araceli
%A Nodar, Juan Miguel Ruiz
%A Garcia, Koldobika
%A Saez, Roberto
%A Torres, Alfonso
%A Telleria, Miren
%A Sadaba, Mario
%A Minguez, Jose Ramon Lopez
%A Merchan, Juan Carlos Rama
%A Portales, Javier
%A Trillo, Ramiro
%A Aldama, Guillermo
%A Fernandez, Saleta
%A Santas, Melisa
%A Perez, Maria Pilar Portero
%T Impacto de la COVID-19 en el tratamiento del infarto agudo de miocardio con elevación del segmento ST. La experiencia española.
%D 2020
%U http://hdl.handle.net/10668/16442
%X The COVID-19 outbreak has had an unclear impact on the treatment and outcomes of patients with ST-segment elevation myocardial infarction (STEMI). The aim of this study was to assess changes in STEMI management during the COVID-19 outbreak. Using a multicenter, nationwide, retrospective, observational registry of consecutive patients who were managed in 75 specific STEMI care centers in Spain, we compared patient and procedural characteristics and in-hospital outcomes in 2 different cohorts with 30-day follow-up according to whether the patients had been treated before or after COVID-19. Suspected STEMI patients treated in STEMI networks decreased by 27.6% and patients with confirmed STEMI fell from 1305 to 1009 (22.7%). There were no differences in reperfusion strategy (> 94% treated with primary percutaneous coronary intervention in both cohorts). Patients treated with primary percutaneous coronary intervention during the COVID-19 outbreak had a longer ischemic time (233 [150-375] vs 200 [140-332] minutes, P  94% treated with primary percutaneous coronary intervention in both cohorts). Patients treated with primary percutaneous coronary intervention during the COVID-19 outbreak had a longer ischemic time (233 [150-375] vs 200 [140-332] minutes, P  The number of STEMI patients treated during the current COVID-19 outbreak fell vs the previous year and there was an increase in the median time from symptom onset to reperfusion and a significant 2-fold increase in the rate of in-hospital mortality. No changes in reperfusion strategy were detected, with primary percutaneous coronary intervention performed for the vast majority of patients. The co-existence of STEMI and SARS-CoV-2 infection was relatively infrequent.
%X Introducción y objetivos: El impacto del brote de COVID-19 en el tratamiento del infarto agudo de miocardio con elevación del segmento ST (IAMCEST) no esta´ claro. El objetivo de este estudio es evaluar los cambios en el tratamiento del IAMCEST durante el brote de COVID-19. Métodos: Se utilizo´ un registro multice´ntrico, nacional, retrospectivo y observacional de pacientes consecutivos atendidos en 75 centros, se compararon las caracterı´sticas de los pacientes y de los procedimientos y los resultados hospitalarios en 2 cohortes segu´ n se los hubiera tratado antes o durantela COVID-19. Resultados: Los casos con sospecha de IAMCEST disminuyeron el 27,6% y los pacientes con IAMCEST confirmado se redujeron de 1.305 a 1.009 (22,7%). No hubo diferencias en la estrategia de reperfusio´n(ma´ s del 94% tratados con angioplastia primaria). El tiempo de isquemia fue ma´ s largo durante la COVID-19 (233 [150-375] frente a 200 [140-332] min; p < 0,001), sin diferencias en el tiempo primer contacto me´dico-reperfusio´n. La mortalidad hospitalaria fue mayor durante la COVID-19 (el 7,5 frente al 5,1%; OR bruta = 1,50; IC95%, 1,07-2,11; p < 0,001); esta asociacio´n se mantuvo tras ajustar por factores de confusio´n (OR ajustada = 1,88; IC95%, 1,12-3,14; p = 0,017). La incidencia de infeccio´n confirmada por SARS-CoV-2 fue del 6,3%. Conclusiones: El brote de COVID-19 ha implicado una disminucio´n en el nu´ mero de pacientes conIAMCEST, un aumento del tiempo entre el inicio de los sı´ntomas y la reperfusio´n y un aumento en la mortalidad hospitalaria. No se han detectado cambios en la estrategia de reperfusio´n. La combinacio´n de infeccio´n por SARS-CoV-2 e IAMCEST fue relativamente infrecuente.
%K COVID-19
%K Primary angioplasty
%K STEMI
%K STEMI network
%K Angioplastia primaria
%K Red de atención al infarto
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