Impact of COVID-19 Pandemic on Patients with ST-Segment-Elevation Myocardial Infarction Complicated by Out-of-Hospital Cardiac Arrest

Tomasz Tokarek (), Artur Dziewierz, Aleksander Zeliaś, Krzysztof Piotr Malinowski, Tomasz Rakowski, Dariusz Dudek and Zbigniew Siudak
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Tomasz Tokarek: Center for Invasive Cardiology, Electrotherapy and Angiology, 33-300 Nowy Sacz, Poland
Artur Dziewierz: Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Krakow, Poland
Aleksander Zeliaś: Center for Invasive Cardiology, Electrotherapy and Angiology, 33-300 Nowy Sacz, Poland
Krzysztof Piotr Malinowski: Digital Medicine & Robotics Center, Jagiellonian University Medical College, 31-034 Krakow, Poland
Tomasz Rakowski: Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Krakow, Poland
Dariusz Dudek: Center for Invasive Cardiology, Electrotherapy and Angiology, 33-300 Nowy Sacz, Poland
Zbigniew Siudak: Faculty of Medicine and Health Science, Jan Kochanowski University, 25-317 Kielce, Poland

IJERPH, 2022, vol. 20, issue 1, 1-10

Abstract: Patients with ST-segment-elevation myocardial infarction (STEMI) treated during the COVID-19 pandemic might experience prolonged time to reperfusion. The delayed reperfusion may potentially aggravate the risk of out-of-hospital cardiac arrest (OHCA) in those patients. Limited access to healthcare, more reluctant health-seeking behaviors, and bystander readiness to render life-saving interventions might additionally contribute to the suggested change in the risk of OHCA in STEMI. Thus, we sought to explore the effects of the COVID-19 outbreak on treatment delay and clinical outcomes of patients with STEMI with OHCA. Overall, 5,501 consecutive patients with STEMI complicated by OHCA and treated with primary percutaneous coronary intervention with stent implantation were enrolled. A propensity score matching was used to obviate the possible impact of non-randomized design. A total of 740 matched pairs of patients with STEMI and OHCA treated before and during the COVID-19 pandemic were compared. A similar mortality and prevalence of periprocedural complications were observed in both groups. However, patients treated during the COVID-19 outbreak experienced longer delays from first medical contact to angiography (88.8 (±61.5) vs. 101.4 (±109.8) [minutes]; p = 0.006). There was also a trend toward prolonged time from pain onset to angiography in patients admitted to the hospital in the pandemic era (207.3 (±192.8) vs. 227.9 (±231.4) [minutes]; p = 0.06). In conclusion, the periprocedural outcomes in STEMI complicated by OHCA were comparable before and during the COVID-19 era. However, treatment in the COVID-19 outbreak was associated with a longer time from first medical contact to reperfusion.

Keywords: STEMI; COVID-19; out-of-hospital cardiac arrest (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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