Journal article
Impact of COVID-19 pandemic and diabetes on mechanical reperfusion in patients with STEMI: insights from the ISACS STEMI COVID 19 Registry
Cardiovascular diabetology, Vol.19(1), pp.215-215
12/18/2020
DOI: 10.1186/s12933-020-01196-0
PMCID: PMC7747477
PMID: 33339541
Abstract
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.
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.
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.
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.
NCT04412655.
Details
- Title: Subtitle
- Impact of COVID-19 pandemic and diabetes on mechanical reperfusion in patients with STEMI: insights from the ISACS STEMI COVID 19 Registry
- Creators
- Giuseppe De Luca - Azienda Ospedaliero Universitaria Maggiore della CaritaMiha Cercek - Ljubljana University Medical CentreLisette Okkels Jensen - Odense University HospitalMarija Vavlukis - Saints Cyril and Methodius University of SkopjeLucian Calmac - Clinical Emergency Hospital BucharestTom Johnson - University of BristolGerard Roura I Ferrer - Interventional Cardiology Unit, Heart Disease Institute, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, SpainVladimir Ganyukov - Kemerovo State UniversityWojtek Wojakowski - Medical University of SilesiaClemens von Birgelen - Medisch Spectrum TwenteFrancesco Versaci - Ospedale Santa Maria GorettiJurrien Ten Berg - Division of Cardiology, St Antonius Hospital, Nieuwegein, The NetherlandsMika Laine - Helsinki University HospitalMaurits Dirksen - Northwest HospitalGianni Casella - Ospedale MaggiorePetr Kala - Masaryk UniversityJosé Luis Díez Gil - H. Universitario y Politécnico La Fe, Valencia, SpainVictor Becerra - Hospital Clínico Universitario Virgen de la VictoriaCiro De Simone - Division of Cardiology, Clinica Villa dei Fiori, Acerra, ItalyXavier Carrill - Hospital Universitari Germans Trias i PujolAlessandra Scoccia - Ospedale Sant'AnnaArpad Lux - Maastricht UniversityTomas Kovarnik - General University Hospital in PraguePeriklis Davlouros - General University Hospital of PatrasGabriele Gabrielli - Azienda Ospedaliero Universitaria Ospedali RiunitiXacobe Flores Rios - Complexo Hospitaliero Universitario La Coruna, La Coruna, SpainNikola Bakraceski - Center for Cardiovascular Diseases, Ohrid, North MacedoniaSébastien Levesque - Centre Hospitalier Universitaire de PoitiersVincenzo Guiducci - Azienda Sanitaria Unità Locale di Reggio EmiliaMichał Kidawa - Medical University of LodzLucia Marinucci - Ospedali Riuniti Marche NordFilippo Zilio - Ospedale Santa ChiaraGennaro Galasso - Ospedali Riuniti San Giovanni di Dio e Ruggi d'AragonaEnrico Fabris - Azienda Sanitaria Universitaria Integrata di TriesteMaurizio Menichelli - Division of Cardiology, Ospedale "F. Spaziani, Frosinone, ItalyStephane Manzo - Assistance Publique – Hôpitaux de ParisGianluca Caiazzo - Azienda Ospedaliera S.Giuseppe MoscatiJose Moreu - Complejo Hospitalario Universitario de ToledoJuan Sanchis Forés - Hospital Clínico Universitario de ValenciaLuca Donazzan - Ospedale di BolzanoLuigi Vignali - Interventional Cardiology Unit, Azienda Ospedaliera Sanitaria, Parma, ItalyRui Teles - Hospital de Santa CruzFrancisco Bosa Ojeda - Hospital Universitario de CanariasHeidi Lehtola - Oulu University HospitalSantiago Camacho-Freiere - Hospital Juan Ramón JiménezAdriaan Kraaijeveld - University Medical Center UtrechtYlitalo Antti - Turku PET CentreMarco Boccalatte - Ospedale Santa MariaIñigo Lozano Martínez-Luengas - Hospital de CabueñesBruno Scheller - Saarland UniversityDimitrios Alexopoulos - University General Hospital AttikonGiuseppe Uccello - Alessandro Manzoni HospitalBenjamin Faurie - Groupe Hospitalier Mutualiste de GrenobleAlejandro Gutierrez Barrios - Division of Cardiology, Hospital Puerta del Mar, Cadiz, SpainBor Wilbert - Division of Cardiology, St Antonius Hospital, Nieuwegein, The NetherlandsGiuliana Cortese - University of PaduaRaul Moreno - Hospital Universitario La PazGuido Parodi - Azienda Ospedaliero Universitaria di SassariElvin Kedhi - AZ Sint-JanMonica Verdoia - Ospedale degli Infermi
- Resource Type
- Journal article
- Publication Details
- Cardiovascular diabetology, Vol.19(1), pp.215-215
- DOI
- 10.1186/s12933-020-01196-0
- PMID
- 33339541
- PMCID
- PMC7747477
- ISSN
- 1475-2840
- eISSN
- 1475-2840
- Language
- English
- Date published
- 12/18/2020
- Academic Unit
- Electrical and Computer Engineering
- Record Identifier
- 9984627230202771
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