Kwok, CS;
Gale, CP;
Kinnaird, T;
Curzen, N;
Ludman, P;
Kontopantelis, E;
Wu, J;
... Mamas, M; + view all
(2020)
Impact of COVID-19 on percutaneous coronary intervention for ST-elevation myocardial infarction.
Heart
, 106
(23)
pp. 1805-1811.
10.1136/heartjnl-2020-317650.
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Abstract
Background: The objective of the study was to identify any changes in primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI) in England by analysing procedural numbers, clinical characteristics and patient outcomes during the COVID-19 pandemic. Methods: We conducted a retrospective cohort study of patients who underwent PCI in England between January 2017 and April 2020 in the British Cardiovascular Intervention Society-National Institute of Cardiovascular Outcomes Research database. Analysis was restricted to 44 hospitals that reported contemporaneous activity on PCI. Only patients with primary PCI for STEMI were included in the analysis. Results: A total of 34 127 patients with STEMI (primary PCI 33 938, facilitated PCI 108, rescue PCI 81) were included in the study. There was a decline in the number of procedures by 43% (n=497) in April 2020 compared with the average monthly procedures between 2017 and 2019 (n=865). For all patients, the median time from symptom to hospital showed increased after the lockdown (150 (99–270) vs 135 (89–250) min, p=0.004) and a longer door-to-balloon time after the lockdown (48 (21–112) vs 37 (16–94) min, p<0.001). The in-hospital mortality rate was 4.8% before the lockdown and 3.5% after the lockdown (p=0.12). Following adjustment for baseline characteristics, no differences were observed for in-hospital death (OR 0.87, 95% CI 0.45 to 1.68, p=0.67) and major adverse cardiovascular events (OR 0.71, 95% CI 0.39 to 1.32, p=0.28). Conclusions: Following the lockdown in England, we observed a decline in primary PCI procedures for STEMI and increases in overall symptom-to-hospital and door-to-balloon time for patients with STEMI. Restructuring health services during COVID-19 has not adversely influenced in-hospital outcomes.
| Type: | Article |
|---|---|
| Title: | Impact of COVID-19 on percutaneous coronary intervention for ST-elevation myocardial infarction |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1136/heartjnl-2020-317650 |
| Publisher version: | https://doi.org/10.1136/heartjnl-2020-317650 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | acute myocardial infarction, percutaneous coronary intervention, Aged, Betacoronavirus, COVID-19, Communicable Disease Control, Coronavirus Infections, England, Female, Hospital Mortality, Humans, Male, Middle Aged, Pandemics, Percutaneous Coronary Intervention, Pneumonia, Viral, Procedures and Techniques Utilization, Retrospective Studies, SARS-CoV-2, ST Elevation Myocardial Infarction, Time-to-Treatment, Treatment Outcome |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Clinical Science |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10211235 |
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