Impact of COVID-19 on door-to-wire time in ST-segment elevation myocardial infarction treatment: the role of digital communication

Abstract

Abstract Introduction ST-segment elevation myocardial infarction (STEMI) is a life-threatening cardiovascular emergency necessitating rapid reperfusion. During the COVID-19 pandemic, healthcare providers faced the challenge of ensuring timely STEMI interventions while managing the risk of viral transmission in hospitals. This study aims to analyze changes in the door-to-wire (D-to-W) time for STEMI treatment across three pandemic phases—early pre-epidemic phase (Group C), initial lockdown phase (Group A), and intermediate normalization phase (Group B). It also examines the impact of digital communication tools, collectively referred to as “InterNet+” (e.g., Twitter, WeChat), on treatment processes. Methods Based on data of 630 STEMI patients treated in Chest Pain Center in a particular hospital in China from 2019 to 2020, changes in D-to-W time in different groups are measured. Time intervals in STEMI treatment process are also predicted by Bayesian statistics approach. The study investigated the influence of InterNet+ utilization before and after the pandemic through a questionnaire-based assessment. Results For transfer-non-emergency- treatment, the time from first-electrocardiogram to preliminary-diagnosis in Group-A is significantly longer than that in Groups-B and -C (p = 0.004, p = 0.004); the time from decision-on-intervention to catheterization-room-activation in Group-A and -B is significantly longer than that in Group-C (p = 0.003, p < 0.001). For transfer-emergency- treatment, the time from first-medical-contact to arterial-puncture in Group-A and -B is remarkably shorter than that in Group-C (p = 0.006). Meanwhile, Bayesian method performs well in forecasting time intervals, so it can provide effective assistance for STEMI treatment. The findings from the questionnaire indicated that physicians perceived a significant association between the optimal management of STEMI and an increased frequency of InterNet+ tool usage following the pandemic (p = 0.019). Conclusions The treatment and management of STEMI patients have been in dilemmas and various time intervals of D-to-W are inevitably prolonged during the COVID-19 pandemic. The implementation of InterNet + tools proved essential for minimizing delays in D-to-W and FMC-to-W times, offering a valuable strategy for enhancing STEMI care amid ongoing pandemic challenges. Clinical trial number Not applicable.

Keywords

• COVID-19
• Chest pain center
• ST-segment elevation myocardial infarction
• D-to-W
• Time prediction