Vol 78, No 12 (2020)
Original article
Published online: 2020-09-21

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The impact of a dedicated coronavirus disease 2019 primary angioplasty protocol on time components related to ST‑segment elevation myocardial infarction management in a 24/7 primary percutaneous coronary intervention–capable hospital

Mojtaba Salarifar, Mojgan Ghavami, Hamidreza Poorhosseini, Farzad Masoudkabir, Yaser Jenab, Alireza Amirzadegan, Mohammad Alidoosti, Hassan Aghajani, Ali Bozorgi, Kaveh Hosseini, Masoumeh Lotfi-Tokaldany, Seyedeh Hamideh Mortazavi, Afsaneh Aein, Tahere Ahmadian, Saeed Sadeghian
Pubmed: 32955819
Kardiol Pol 2020;78(12):1227-1234.

Abstract

Background: Primary percutaneous coronary intervention (PPCI) as the treatment of choice for ST‑segment elevation myocardial infarction (STEMI) should be rapidly performed. It is necessary to use preventive strategies during the coronavirus disease 2019 (COVID‑19) outbreak, which is an ongoing global concern. However, critical times in STEMI management may be influenced by the implementation of infection control protocols.

Aims: We aimed to investigate the impact of our dedicated COVID‑19 PPCI protocol on time components related to STEMI care and catheterization laboratory personnel safety. A subendpoint analysis to compare patient outcomes at a median time of 70 days during the pandemic with those of patients treated in the preceding year was another objective of our study.

Methods: Patients with STEMI who underwent PPCI were included in this study. Chest computed tomography (CT) and real‑time reverse transcriptase–polymerase chain reaction (rRT‑PCR) tests were performed in patients suspected of having COVID‑19. A total of 178 patients admitted between February 29 and April 30, 2020 were compared with 146 patients admitted between March 1 and April 30, 2019.

Results: Severe acute respiratory syndrome coronavirus 2 infection was confirmed by rRT‑PCR in 7 cases. In 6 out of 7 patients, CT was indicative of COVID‑19. There were no differences between the study groups regarding critical time intervals for reperfusion in STEMI. The 70‑day mortality rate before and during the pandemic was 2.73% and 4.49%, respectively (P = 0.4).

Conclusions: The implementation of the dedicated COVID‑19 PPCI protocol in patients with STEMI allowed us to achieve similar target times for reperfusion, short‑term clinical outcomes, and staff safety as in the prepandemic era.

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Polish Heart Journal (Kardiologia Polska)