Treatment delay and clinical outcomes in patients with st‐segment elevation myocardial infarction during the covid‐19 pandemic

Abstract

Pandemic‐specific protocols require additional time to prepare medical staff and catheterization laboratories. Thus, we sought to investigate treatment delay and clinical outcomes in COVID‐19 positive and negative patients with ST‐segment elevation myocardial infarction (STEMI) treated with percutaneous coronary intervention (PCI) during on‐ and off‐hours. All consecutive patients with STEMI treated with PCI between 1 March and 31 December 2020 were enrolled in the analysis. A propensity score match was used to compare COVID‐19 positive and negative patients for on‐ and off‐hours. The study group was comprised of 877 paired patients treated during regular hours (every day 7:00 a.m. to 16:59 p.m.) and 418 matched pairs with PCI performed during off‐hours (every day 17:00 p.m. to 06:59 a.m.) (ORPKI Polish National Registry). No difference in periprocedural mortality was observed between the two groups (on‐hours: COVID‐19 negative vs. COVID‐19 positive: 17 (1.9%) vs. 11 (1.3%); p = 0.3; off‐hours: COVID‐19 negative vs. COVID‐19 positive: 4 (1.0%) vs. 7 (1.7%); p = 0.5). Additionally, a similar rate of periprocedural complications was reported. Patients diagnosed with COVID‐19 were exposed to longer time from first medical contact to angiography (on‐hours: 133.8 (±137.1) vs. 117.1 (±135.8) (min); p = 0.001) (off‐hours: 148.1 (±201.6) vs. 112.2 (±138.7) (min); p = 0.003). However, there was no influence of COVID‐19 diagnosis on mortality and the prevalence of other periprocedural complications irrespective of time of intervention.