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Tokarek T, Dziewierz A, Malinowski KP, Rakowski T, Bartuś S, Dudek D, Siudak Z. Treatment Delay and Clinical Outcomes in Patients with ST-Segment Elevation Myocardial Infarction during the COVID-19 Pandemic. J Clin Med 2021; 10:jcm10173920. [PMID: 34501369 PMCID: PMC8432080 DOI: 10.3390/jcm10173920] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 08/18/2021] [Accepted: 08/27/2021] [Indexed: 02/02/2023] Open
Abstract
Pandemic-specific protocols require additional time to prepare medical staff and catheterization laboratories. Thus, we sought to investigate treatment delay and clinical outcomes in COVID-19 positive and negative patients with ST-segment elevation myocardial infarction (STEMI) treated with percutaneous coronary intervention (PCI) during on- and off-hours. All consecutive patients with STEMI treated with PCI between 1 March and 31 December 2020 were enrolled in the analysis. A propensity score match was used to compare COVID-19 positive and negative patients for on- and off-hours. The study group was comprised of 877 paired patients treated during regular hours (every day 7:00 a.m. to 16:59 p.m.) and 418 matched pairs with PCI performed during off-hours (every day 17:00 p.m. to 06:59 a.m.) (ORPKI Polish National Registry). No difference in periprocedural mortality was observed between the two groups (on-hours: COVID-19 negative vs. COVID-19 positive: 17 (1.9%) vs. 11 (1.3%); p = 0.3; off-hours: COVID-19 negative vs. COVID-19 positive: 4 (1.0%) vs. 7 (1.7%); p = 0.5). Additionally, a similar rate of periprocedural complications was reported. Patients diagnosed with COVID-19 were exposed to longer time from first medical contact to angiography (on-hours: 133.8 (±137.1) vs. 117.1 (±135.8) (min); p = 0.001) (off-hours: 148.1 (±201.6) vs. 112.2 (±138.7) (min); p = 0.003). However, there was no influence of COVID-19 diagnosis on mortality and the prevalence of other periprocedural complications irrespective of time of intervention.
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Affiliation(s)
- Tomasz Tokarek
- Department of Cardiology and Cardiovascular Interventions, University Hospital, 2 Jakubowskiego St., 30-688 Krakow, Poland; (A.D.); (T.R.); (S.B.)
- Center for Intensive Care and Perioperative Medicine, Jagiellonian University Medical College, 31-008 Krakow, Poland
- Correspondence: ; Tel.: +48-12-400-22-62
| | - Artur Dziewierz
- Department of Cardiology and Cardiovascular Interventions, University Hospital, 2 Jakubowskiego St., 30-688 Krakow, Poland; (A.D.); (T.R.); (S.B.)
- 2nd Department of Cardiology, Jagiellonian University Medical College, 31-008 Krakow, Poland; (K.P.M.); (D.D.)
| | - Krzysztof Piotr Malinowski
- 2nd Department of Cardiology, Jagiellonian University Medical College, 31-008 Krakow, Poland; (K.P.M.); (D.D.)
| | - Tomasz Rakowski
- Department of Cardiology and Cardiovascular Interventions, University Hospital, 2 Jakubowskiego St., 30-688 Krakow, Poland; (A.D.); (T.R.); (S.B.)
- 2nd Department of Cardiology, Jagiellonian University Medical College, 31-008 Krakow, Poland; (K.P.M.); (D.D.)
| | - Stanisław Bartuś
- Department of Cardiology and Cardiovascular Interventions, University Hospital, 2 Jakubowskiego St., 30-688 Krakow, Poland; (A.D.); (T.R.); (S.B.)
- 2nd Department of Cardiology, Jagiellonian University Medical College, 31-008 Krakow, Poland; (K.P.M.); (D.D.)
| | - Dariusz Dudek
- 2nd Department of Cardiology, Jagiellonian University Medical College, 31-008 Krakow, Poland; (K.P.M.); (D.D.)
| | - Zbigniew Siudak
- Faculty of Medicine and Health Science, Jan Kochanowski University, 25-369 Kielce, Poland;
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