COVID-19 pandemic and STEMI: pathway activation and outcomes from the pan-London heart attack group

• DOI: 10.1136/openhrt-2020-001432
• Publication Date: 2020-10-26T20:15:16Z
• Authors: Callum D Little; Tushar Kotecha; Luciano Candilio; Richard J Jabbour; George B Collins; Asrar Ahmed; Michelle Connolly; Ritesh Kanyal; Ozan M Demir; Lucy O Lawson; Brian Wang; Sam Firoozi; James C Spratt; Divaka Perera; Philip MacCarthy; Miles Dalby; Ajay Jain; Simon J Wilson; Iqbal Malik; Roby Rakhit
• Keywords: Pandemic

Objectives To understand the impact of COVID-19 on delivery and outcomes primary percutaneous coronary intervention (PPCI). Furthermore, to compare clinical presentation patients with ST-segment elevation myocardial infarction (STEMI) active against those without COVID-19. Methods We systematically analysed 348 STEMI cases presenting PPCI programme in London during peak pandemic (1 March 30 April 2020) compared 440 from same period 2019. Outcomes interest included ambulance response times, timeliness revascularisation, angiographic procedural characteristics, in-hospital Results There was a 21% reduction admissions longer times (87 (62–118) min 2020 vs 75 (57–95) 2019, p<0.001), but that this not associated delays achieving revascularisation once hospital (48 (34–65) 48 (35–70) p=0.35) or increased mortality (10.9% (38) 8.6% p=0.28). 46 were more thrombotic likely have intensive care unit (32.6% (15) 9.3% (28), OR 5.74 (95%CI 2.24 9.89), p<0.001). They also had length stay (4 (3–9) days 3 (2–4) days, p<0.001) higher (21.7% (10) 2.72 (95% CI 1.25 5.82), p=0.012) having Conclusion These findings suggest pathways can be maintained unprecedented healthcare emergencies confirms high context concomitant infection characterised by heightened state thrombogenicity.