Impact of COVID-19 pandemic and diabetes on mechanical reperfusion in patients with STEMI: insights from the ISACS STEMI COVID 19 ... View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2020-12-18

AUTHORS

Giuseppe De Luca, Miha Cercek, Lisette Okkels Jensen, Marija Vavlukis, Lucian Calmac, Tom Johnson, Gerard Roura i Ferrer, Vladimir Ganyukov, Wojtek Wojakowski, Clemens von Birgelen, Francesco Versaci, Jurrien Ten Berg, Mika Laine, Maurits Dirksen, Gianni Casella, Petr Kala, José Luis Díez Gil, Victor Becerra, Ciro De Simone, Xavier Carrill, Alessandra Scoccia, Arpad Lux, Tomas Kovarnik, Periklis Davlouros, Gabriele Gabrielli, Xacobe Flores Rios, Nikola Bakraceski, Sébastien Levesque, Vincenzo Guiducci, Michał Kidawa, Lucia Marinucci, Filippo Zilio, Gennaro Galasso, Enrico Fabris, Maurizio Menichelli, Stephane Manzo, Gianluca Caiazzo, Jose Moreu, Juan Sanchis Forés, Luca Donazzan, Luigi Vignali, Rui Teles, Francisco Bosa Ojeda, Heidi Lehtola, Santiago Camacho-Freiere, Adriaan Kraaijeveld, Ylitalo Antti, Marco Boccalatte, Iñigo Lozano Martínez-Luengas, Bruno Scheller, Dimitrios Alexopoulos, Giuseppe Uccello, Benjamin Faurie, Alejandro Gutierrez Barrios, Bor Wilbert, Giuliana Cortese, Raul Moreno, Guido Parodi, Elvin Kedhi, Monica Verdoia

ABSTRACT

BACKGROUND: It has been suggested the COVID pandemic may have indirectly affected the treatment and outcome of STEMI patients, by avoidance or significant delays in contacting the emergency system. No data have been reported on the impact of diabetes on treatment and outcome of STEMI patients, that was therefore the aim of the current subanalysis conducted in patients included in the International Study on Acute Coronary Syndromes-ST Elevation Myocardial Infarction (ISACS-STEMI) COVID-19. METHODS: The ISACS-STEMI COVID-19 is a retrospective registry performed in European centers with an annual volume of > 120 primary percutaneous coronary intervention (PCI) and assessed STEMI patients, treated with primary PCI during the same periods of the years 2019 versus 2020 (March and April). Main outcomes are the incidences of primary PCI, delayed treatment, and in-hospital mortality. RESULTS: A total of 6609 patients underwent primary PCI in 77 centers, located in 18 countries. Diabetes was observed in a total of 1356 patients (20.5%), with similar proportion between 2019 and 2020. During the pandemic, there was a significant reduction in primary PCI as compared to 2019, similar in both patients with (Incidence rate ratio (IRR) 0.79 (95% CI: 0.73-0.85, p < 0.0001) and without diabetes (IRR 0.81 (95% CI: 0.78-0.85, p < 0.0001) (p int = 0.40). We observed a significant heterogeneity among centers in the population with and without diabetes (p < 0.001, respectively). The heterogeneity among centers was not related to the incidence of death due to COVID-19 in both groups of patients. Interaction was observed for Hypertension (p = 0.024) only in absence of diabetes. Furthermore, the pandemic was independently associated with a significant increase in door-to-balloon and total ischemia times only among patients without diabetes, which may have contributed to the higher mortality, during the pandemic, observed in this group of patients. CONCLUSIONS: The COVID-19 pandemic had a significant impact on the treatment of patients with STEMI, with a similar reduction in primary PCI procedures in both patients with and without diabetes. Hypertension had a significant impact on PCI reduction only among patients without diabetes. We observed a significant increase in ischemia time and door-to-balloon time mainly in absence of diabetes, that contributed to explain the increased mortality observed in this group of patients during the pandemic. TRIAL REGISTRATION NUMBER: NCT04412655. More... »

PAGES

215

Journal

TITLE

Cardiovascular Diabetology

ISSUE

1

VOLUME

19

Author Affiliations

  • Division of Cardiology, Azienda Ospedaliero-Universitaria Maggiore della Carità, Università del Piemonte Orientale, Novara, Italy
  • Centre for Intensive Internal Medicine, University Medical Centre, Ljubljana, Slovenia
  • Division of Cardiology, Odense Universitets Hospital, Odense, Danemark
  • University Clinic for Cardiology, Medical Faculty, Ss’ Cyril and Methodius University, Skopje, North Macedonia
  • Clinic Emergency Hospital of Bucharest, Bucharest, Romania
  • Division of Cardiology, Bristol Heart Institute, University Hospitals Bristol, NHSFT & University of Bristol, Bristol, UK
  • Interventional Cardiology Unit, Heart Disease Institute, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Spain
  • Division of Cardiology, State Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russia
  • Division of Cardiology, Medical University of Silezia, Katowice, Poland
  • Department of Cardiology, Medisch Spectrum Twente, Thoraxcentrum Twente, Enschede, The Netherlands
  • Division of Cardiology, Ospedale Santa Maria Goretti, Latina, Italy
  • Division of Cardiology, St Antonius Hospital, Nieuwegein, The Netherlands
  • Division of Cardiology, Helsinki University Central Hospital, Helsinki, Finland
  • Division of Cardiology, Northwest Clinic, Alkmaar, The Netherlands
  • Division of Cardiology, Ospedale Maggiore, Bologna, Italy
  • University Hospital Brno, Medical Faculty of Masaryk University Brno, Brno, Czech Republic
  • H. Universitario y Politécnico La Fe, Valencia, Spain
  • Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain
  • Division of Cardiology, Clinica Villa dei Fiori, Acerra, Italy
  • Hospital Germans Triasi Pujol, Badalona, Spain
  • Division of Cardiology, Ospedale “Sant’Anna”, Ferrara, Italy
  • Maastricht University Medical Center, Maastricht, The Netherlands
  • University Hospital Prague, Prague, Czech Republic
  • Invasive Cardiology and Congenital Heart Disease, Patras University Hospital, Patras, Greece
  • Interventional Cardiology Unit, Azienda Ospedaliero Universitaria “Ospedali Riuniti”, Ancona, Italy
  • Complexo Hospitaliero Universitario La Coruna, La Coruna, Spain
  • Center for Cardiovascular Diseases, Ohrid, North Macedonia
  • Center Hospitalier, Universitaire de Poitiers, University Hospital, Poitiers, France
  • AUSL-IRCCS Reggio Emilia, Reggio Emilia, Italy
  • Central Hospital of Medical University of Lodz, Łódź, Poland
  • Division of Cardiology, AziendaOspedaliera “Ospedali Riuniti Marche Nord”, Pesaro, Italy
  • Ospedale Santa Chiara di Trento, Trento, Italy
  • Division of Cardiology, Ospedale San Giovanni di Dio e Ruggi d’Aragona, Salerno, Italy
  • Azienda Ospedaliero – Universitaria Ospedali Riuniti Trieste, Trieste, Italy
  • Division of Cardiology, Ospedale “F. Spaziani, Frosinone, Italy
  • Division of Cardiology, CHU Lariboisière, AP-HP, Paris VII University, INSERM UMRS 942, Paris, France
  • Division of Cardiology, Ospedale “G Moscati”, Aversa, Italy
  • Division of Cardiology, Complejo Hospitalario de Toledo, Toledo, Spain
  • Division of Cardiology, Hospital Clinico Universitario de Valencia, Valencia, Spain
  • Division of Cardiology, Ospedale “S. Maurizio” Bolzano Ospedale “S. Maurizio”, Bolzano, Italy
  • Interventional Cardiology Unit, Azienda Ospedaliera Sanitaria, Parma, Italy
  • Division of Cardiology, Hospital de Santa Cruz, CHLO - Carnaxide, Carnaxide, Portugal
  • Division of Cardiology, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain
  • Division of Cardiology, Oulu University Hospital, Oulu, Finland
  • Division of Cardiology, Juan Ramon Jimenez Hospital, Huelva, Spain
  • Division of Cardiology, UMC Utrecht, Utrecht, The Netherlands
  • Division of Cardiology, Heart Centre Turku, Turku, Finland
  • Division of Cardiology, Ospedale Santa Maria delle Grazie, Pozzuoli, Italy
  • Division of Cardiology, Hospital Cabueñes, Gijon, Spain
  • Division of Cardiology, Clinical and Experimental Interventional Cardiology, University of Saarland, Saarbrücken, Germany
  • Division of Cardiology, Attikon University Hospital, Athens, Greece
  • Division of Cardiology, Ospedale “A. Manzoni” Lecco, Lecco, Italy
  • Division of Cardiology, Groupe Hospitalier Mutualiste de Grenoble, Grenoble, France
  • Division of Cardiology, Hospital Puerta del Mar, Cadiz, Spain
  • Department of Statistical Sciences, University of Padova, Padova, Italy
  • Division of Cardiology, Hospital la Paz, Madrid, Spain
  • Azienda Ospedaliero-Universitaria Sassari, Sassari, Italy
  • Division of Cardiology, St-Jan Hospital, Brugge, Belgium
  • Division of Cardiology, Ospedale degli Infermi, ASL Biella, Ponderano, Italy
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1186/s12933-020-01196-0

    DOI

    http://dx.doi.org/10.1186/s12933-020-01196-0

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1133606428

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/33339541


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