Journal of Clinical Medicine (Mar 2023)

Age-Related Effects of COVID-19 Pandemic on Mechanical Reperfusion and 30-Day Mortality for STEMI: Results of the ISACS-STEMI COVID-19 Registry

  • Giuseppe De Luca,
  • Magdy Algowhary,
  • Berat Uguz,
  • Dinaldo C. Oliveira,
  • Vladimir Ganyukov,
  • Oliver Busljetik,
  • Miha Cercek,
  • Lisette Okkels Jensen,
  • Poay Huan Loh,
  • Lucian Calmac,
  • Gerard Roura i Ferrer,
  • Alexandre Quadros,
  • Marek Milewski,
  • Fortunato Scotto D’Uccio,
  • Clemens von Birgelen,
  • Francesco Versaci,
  • Jurrien Ten Berg,
  • Gianni Casella,
  • Aaron Wong Sung Lung,
  • Petr Kala,
  • José Luis Díez Gil,
  • Xavier Carrillo,
  • Maurits Dirksen,
  • Victor Becerra Munoz,
  • Michael Kang-yin Lee,
  • Dafsah Arifa Juzar,
  • Rodrigo de Moura Joaquim,
  • Roberto Paladino,
  • Davor Milicic,
  • Periklis Davlouros,
  • Nikola Bakraceski,
  • Filippo Zilio,
  • Luca Donazzan,
  • Adriaan Kraaijeveld,
  • Gennaro Galasso,
  • Lux Arpad,
  • Lucia Marinucci,
  • Vincenzo Guiducci,
  • Maurizio Menichelli,
  • Alessandra Scoccia,
  • Aylin Hatice Yamac,
  • Kadir Ugur Mert,
  • Xacobe Flores Rios,
  • Tomas Kovarnik,
  • Michal Kidawa,
  • Josè Moreu,
  • Vincent Flavien,
  • Enrico Fabris,
  • Iñigo Lozano Martínez-Luengas,
  • Marco Boccalatte,
  • Francisco Bosa Ojeda,
  • Carlos Arellano-Serrano,
  • Gianluca Caiazzo,
  • Giuseppe Cirrincione,
  • Hsien-Li Kao,
  • Juan Sanchis Forés,
  • Luigi Vignali,
  • Helder Pereira,
  • Stephane Manzo-Silberman,
  • Santiago Ordoñez,
  • Alev Arat Özkan,
  • Bruno Scheller,
  • Heidi Lehitola,
  • Rui Teles,
  • Christos Mantis,
  • Ylitalo Antti,
  • João António Brum Silveira,
  • Cesar Rodrigo Zoni,
  • Ivan Bessonov,
  • Giuseppe Uccello,
  • George Kochiadakis,
  • Dimitrios Alexopulos,
  • Carlos E. Uribe,
  • John Kanakakis,
  • Benjamin Faurie,
  • Gabriele Gabrielli,
  • Alejandro Gutierrez Barrios,
  • Juan Pablo Bachini,
  • Alex Rocha,
  • Frankie C. C. Tam,
  • Alfredo Rodriguez,
  • Antonia Anna Lukito,
  • Veauthyelau Saint-Joy,
  • Gustavo Pessah,
  • Andrea Tuccillo,
  • Alfonso Ielasi,
  • Giuliana Cortese,
  • Guido Parodi,
  • Mohammed Abed Burgadha,
  • Elvin Kedhi,
  • Pablo Lamelas,
  • Harry Suryapranata,
  • Matteo Nardin,
  • Monica Verdoia

DOI
https://doi.org/10.3390/jcm12062116
Journal volume & issue
Vol. 12, no. 6
p. 2116

Abstract

Read online

Background: The constraints in the management of patients with ST-segment elevation myocardial infarction (STEMI) during the COVID-19 pandemic have been suggested to have severely impacted mortality levels. The aim of the current analysis is to evaluate the age-related effects of the COVID-19 pandemic on mechanical reperfusion and 30-day mortality for STEMI within the registry ISACS-STEMI COVID-19. Methods: This retrospective multicenter registry was performed in high-volume PPCI centers on four continents and included STEMI patients undergoing PPCI in March–June 2019 and 2020. Patients were divided according to age (p p = 0.015), with a larger effect on elderly than on younger patients. Furthermore, we observed significantly higher 30-day mortality during the pandemic period, especially among the elderly (13.6% vs. 17.9%, adjusted HR (95% CI) = 1.55 [1.24–1.93], p p = 0.013), as a potential consequence of the significantly longer ischemia time observed during the pandemic. Conclusions: The COVID-19 pandemic had a significant impact on the treatment of patients with STEMI, with a 16% reduction in PPCI procedures, with a larger reduction and a longer delay to treatment among elderly patients, which may have contributed to increase in-hospital and 30-day mortality during the pandemic.

Keywords