Article Data

  • Views 1765
  • Dowloads 152

Original Research

Open Access

Impact of COVID-19 outbreak on patients with ST-segment elevated myocardial infarction undergoing primary percutaneous coronary intervention in a regional emergency center in Seoul, Korea

  • Ha Eun Bae1,2
  • Young-Hoon Yoon1,2
  • Jung-Youn Kim1,2
  • Young-Duck Cho1,2
  • Sung-Hyuk Choi1,2
  • Sung-Joon Park1,2,*,

1Department of Emergency Medicine, College of Medicine, Korea University, 02841 Seoul, Republic of Korea

2Department of Emergency Medicine, Korea University Guro Hospital, 08308 Seoul, Republic of Korea

DOI: 10.22514/sv.2023.008 Vol.19,Issue 3,May 2023 pp.165-172

Submitted: 08 June 2022 Accepted: 26 July 2022

Published: 08 May 2023

*Corresponding Author(s): Sung-Joon Park E-mail: kuedpsj@hanmail.net

Abstract

The corona virus disease 2019 (COVID-19) outbreak may have delayed the treatment of patients with ST-segment elevated myocardial infarction (STEMI) in the emergency department (ED). This study aimed to determine the causes for treatment delay and evaluate the outcomes of such delays in STEMI patients undergoing primary percutaneous coronary intervention. This was a single-center retrospective observational study. Hospital records of STEMI patients who received primary percutaneous coronary intervention from 01 January 2019, to 31 December 2020, were assessed. The pre-COVID-19 period was set before 01 January 2020, and the COVID-19 period was set after 01 January 2020, following which the data between these two periods were compared. During the COVID-19 period, there was a decrease in the reported incidence of STEMI patients compared with during the pre-COVID-19 period (incidence rate ratio, 0.74; 95% confidence interval, 0.55–0.99; p = 0.04). After arrival at ED, the time from door to balloon significantly differed between the pre-COVID-19 and COVID-19 period (78.0 min vs. 102.0 min, p < 0.001). Also, the time to alert a cardiologist (16 min vs. 9 min), puncture time after cardiologist arrival (57 min vs. 42 min), and puncture to balloon time (19 min vs. 14 min) were significantly longer during the COVID period. However, the time from alert to cardiologist arrival was similar. Compared to the pre-COVID 19 period, more patients suffered from major adverse cardiac events during the COVID-19 period (n = 20 (25.3%) vs. n = 12 (11.2%), p = 0.012). In both periods, the number of patients admitted to the intensive care unit and died (106 vs. 79, 9 vs. 10, respectively) and the number of days spent in the ICU were similar. Early recognition of critically ill patients and appropriate response in the ED can lower misdiagnosis rates and increase prompt and correct treatments, thereby improving patient prognosis.


Keywords

COVID-19; ST-segment elevated myocardial infarction; Acute myocardial infarct; Percutaneous coronary intervention


Cite and Share

Ha Eun Bae,Young-Hoon Yoon,Jung-Youn Kim,Young-Duck Cho,Sung-Hyuk Choi,Sung-Joon Park. Impact of COVID-19 outbreak on patients with ST-segment elevated myocardial infarction undergoing primary percutaneous coronary intervention in a regional emergency center in Seoul, Korea. Signa Vitae. 2023. 19(3);165-172.

References

[1] Cucinotta D, Vanelli M. WHO declares COVID-19 a pandemic. Acta Biomedica. 2020; 91: 157–160.

[2] Guan W, Ni Z, Hu Y, Liang W, Ou C, He J, et al. Clinical characteristics of coronavirus disease 2019 in China. New England Journal of Medicine. 2020; 382: 1708–1720.

[3] WHO. Infection prevention and control in the context of coronavirus disease (COVID-19): A living guideline, 2022. Available at: https://www.who.int/publications/i/item/WHO-2019-nCoV-ipc-guideline-2022.2 (Accessed: 13 July 2022).

[4] Coronavirus (COVID-19) status, Republic of Korea. Available at: http: //ncov.mohw.go.kr/en/ (Accessed: 13 July 2022).

[5] WHO Coronavirus Disease (COVID-19) Dashboard. Available at: https://covid19.who.int/ (Accessed: 13 July 2022).

[6] De Luca G, Suryapranata H, Ottervanger JP, Antman EM. Time delay to treatment and mortality in primary angioplasty for acute myocardial infarction. Circulation. 2004; 109: 1223–1225.

[7] Wijns W, Naber CK. Reperfusion delay in patients with high-risk ST-segment elevation myocardial infarction: every minute counts, much more than suspected. European Heart Journal. 2018; 39: 1075–1077.

[8] Park J, Choi KH, Lee JM, Kim HK, Hwang D, Rhee T, et al. Prognostic implications of door-to-balloon time and onset-to-door time on mortality in patients with ST-segment-elevation myocardial infarction treated with primary percutaneous coronary intervention. Journal of the American Heart Association. 2019; 8: e012188.

[9] Mayol J, Artucio C, Batista I, Puentes A, Villegas J, Quizpe R, et al. An international survey in Latin America on the practice of interventional cardiology during the COVID-19 pandemic, with a particular focus on myocardial infarction. Netherlands Heart Journal. 2020; 28: 424-430.

[10] Rodríguez-Leor O, Cid-Álvarez B, Ojeda S, Martín-Moreiras J, Ramón Rumoroso J, López-Palop R, et al. Impact of the COVID-19 pandemic on interventional cardiology activity in Spain. REC: Interventional Cardiology. 2020; 2: 82–89.

[11] Tam CF, Cheung KS, Lam S, Wong A, Yung A, Sze M, et al. Impact of coronavirus disease 2019 (COVID-19) outbreak on outcome of myocardial infarction in Hong Kong, China. Catheterization and Cardiovascular Interventions. 2021; 97: E194–E197.

[12] Chew NW, Sia C, Wee H, Benedict LJ, Rastogi S, Kojodjojo P, et al. Impact of the COVID-19 pandemic on door-to-balloon time for primary percutaneous coronary intervention—results from the Singapore western STEMI network—. Circulation Journal. 2021; 85: 139–149.

[13] Li Y, Huang W, Hwang J. No reduction of ST-segment elevation myocardial infarction admission in Taiwan during coronavirus pandemic. The American Journal of Cardiology. 2020; 131: 133–134.

[14] Sofi F, Dinu M, Reboldi G, Stracci F, Pedretti RFE, Valente S, et al. Worldwide differences of hospitalization for ST-segment elevation myocardial infarction during COVID-19: a systematic review and meta-analysis. International Journal of Cardiology. 2022; 347: 89–96.

[15] Tam CF, Cheung KS, Lam S, Wong A, Yung A, Sze M, et al. Impact of coronavirus disease 2019 (COVID-19) outbreak on ST-segment-elevation myocardial infarction care in Hong Kong, China. Circulation. Cardiovascular Quality and Outcomes. 2020; 13: e006631.

[16] Solomon MD, McNulty EJ, Rana JS, Leong TK, Lee C, Sung S, et al. The Covid-19 pandemic and the incidence of acute myocardial infarction. New England Journal of Medicine. 2020; 383: 691–693.

[17] Garcia S, Albaghdadi MS, Meraj PM, Schmidt C, Garberich R, Jaffer FA, et al. Reduction in ST-segment elevation cardiac catheterization laboratory activations in the United States during COVID-19 pandemic. Journal of the American College of Cardiology. 2020; 75: 2871–2872.

[18] Bhatt AS, Moscone A, McElrath EE, Varshney AS, Claggett BL, Bhatt DL, et al. Fewer hospitalizations for acute cardiovascular conditions during the COVID-19 pandemic. Journal of the American College of Cardiology. 2020; 76: 280–288.

[19] Roffi M, Guagliumi G, Ibanez B. The obstacle course of reperfusion for ST-segment-elevation myocardial infarction in the COVID-19 pandemic. Circulation. 2020; 141: 1951–1953.

[20] Hammad TA, Parikh M, Tashtish N, Lowry CM, Gorbey D, Forouzandeh F, et al. Impact of COVID-19 pandemic on ST-elevation myocardial infarction in a non-COVID-19 epicenter. Catheterization and Cardiovascular Interventions. 2021; 97: 208–214.

[21] Yu IT, Xie ZH, Tsoi KK, Chiu YL, Lok SW, Tang XP, et al. Why did outbreaks of severe acute respiratory syndrome occur in some hospital wards but not in others? Clinical Infectious Diseases. 2007; 44: 1017–1025.

[22] Kim SW, Park JW, Jung HD, Yang JS, Park YS, Lee C, et al. Risk factors for transmission of middle east respiratory syndrome coronavirus infection during the 2015 outbreak in South Korea. Clinical Infectious Diseases. 2017; 64: 551-–557.

[23] Sorci G, Faivre B, Morand S. Why does COVID-19 case fatality rate vary among countries? To be published in medRxiv. 2020. [Preprint].

[24] Sorci G, Faivre B, Morand S. Explaining among-country variation in COVID-19 case fatality rate. Scientific Reports. 2020; 10: 18909.



Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Chemical Abstracts Service Source Index The CAS Source Index (CASSI) Search Tool is an online resource that can quickly identify or confirm journal titles and abbreviations for publications indexed by CAS since 1907, including serial and non-serial scientific and technical publications.

Index Copernicus The Index Copernicus International (ICI) Journals database’s is an international indexation database of scientific journals. It covered international scientific journals which divided into general information, contents of individual issues, detailed bibliography (references) sections for every publication, as well as full texts of publications in the form of attached files (optional). For now, there are more than 58,000 scientific journals registered at ICI.

Geneva Foundation for Medical Education and Research The Geneva Foundation for Medical Education and Research (GFMER) is a non-profit organization established in 2002 and it works in close collaboration with the World Health Organization (WHO). The overall objectives of the Foundation are to promote and develop health education and research programs.

Scopus: CiteScore 1.0 (2022) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Embase Embase (often styled EMBASE for Excerpta Medica dataBASE), produced by Elsevier, is a biomedical and pharmacological database of published literature designed to support information managers and pharmacovigilance in complying with the regulatory requirements of a licensed drug.

Submission Turnaround Time

Conferences

Top