Introduction During Coronavirus disease 2019 (COVID-19) pandemic a reduction in ST-elevation acute myocardial infarction with an increase in in-hospital mortality has been observed. In our region the pandemic temporal trend was sinusoidal with peaks and valleys. A first outbreak was in March 2020, a reduction in May 2020 and a second outbreak in November 2020. Matherials & methods Our hospital was reorganized as one of the 13 Macro-Hubs identified in Lombardy and we retrospectively analysed consecutive STEMI patients hospitalized in the three different phases of COVID-19 pandemic. Results We did not register any difference in the number of STEMI hospitalized in the three phases. At multivariate analysis for the entire population COVID-19 infection was the strongest independent predictor of in-hospital mortality. Focusing on COVID-19 patients they experienced a 5-time increased incidence of in-hospital mortality (COVID-19pos vs COVID-19neg, 47.1% vs 8.6%; p < 0.0001) mainly driven by a higher incidence of respiratory complications (COVID-19pos vs COVID-19neg, 41.2% vs 6.2%; p < 0.0001) with a similar incidence of cardiac death. Discussion Among STEMI admitted during different phases of pandemic, this study found an increased mortality in patients affected by COVID-19; the co-presence of COVID-19 infection leads to an increase of mortality mostly related to respiratory complications. Interestingly the different incidence in the general population of COVID-19 did not influence the incidence of STEMI. Conclusion In conclusion our data suggest the crucial need for an early and precise diagnosis of COVID-19 infection in STEMI to establish a correct management of these very high-risk patients.

Influence of different COVID-19 pandemic phases on STEMI: Experience from an Italian Hub centre / G. Tumminello, L. Barbieri, F. Toriello, S. Lucreziotti, M. Carlà, B. Conconi, A. Mafrici, S. Carugo. - In: CARDIOVASCULAR REVASCULARIZATION MEDICINE. - ISSN 1553-8389. - (2021), pp. 1-4. [Epub ahead of print] [10.1016/j.carrev.2021.07.009]

Influence of different COVID-19 pandemic phases on STEMI: Experience from an Italian Hub centre.

F. Toriello;S. Carugo
Ultimo
2021

Abstract

Introduction During Coronavirus disease 2019 (COVID-19) pandemic a reduction in ST-elevation acute myocardial infarction with an increase in in-hospital mortality has been observed. In our region the pandemic temporal trend was sinusoidal with peaks and valleys. A first outbreak was in March 2020, a reduction in May 2020 and a second outbreak in November 2020. Matherials & methods Our hospital was reorganized as one of the 13 Macro-Hubs identified in Lombardy and we retrospectively analysed consecutive STEMI patients hospitalized in the three different phases of COVID-19 pandemic. Results We did not register any difference in the number of STEMI hospitalized in the three phases. At multivariate analysis for the entire population COVID-19 infection was the strongest independent predictor of in-hospital mortality. Focusing on COVID-19 patients they experienced a 5-time increased incidence of in-hospital mortality (COVID-19pos vs COVID-19neg, 47.1% vs 8.6%; p < 0.0001) mainly driven by a higher incidence of respiratory complications (COVID-19pos vs COVID-19neg, 41.2% vs 6.2%; p < 0.0001) with a similar incidence of cardiac death. Discussion Among STEMI admitted during different phases of pandemic, this study found an increased mortality in patients affected by COVID-19; the co-presence of COVID-19 infection leads to an increase of mortality mostly related to respiratory complications. Interestingly the different incidence in the general population of COVID-19 did not influence the incidence of STEMI. Conclusion In conclusion our data suggest the crucial need for an early and precise diagnosis of COVID-19 infection in STEMI to establish a correct management of these very high-risk patients.
Acute myocardial infarction; Percutaneous coronary intervention; Primary PCI;
Settore MED/11 - Malattie dell'Apparato Cardiovascolare
7-lug-2021
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/868356
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