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August 14, 2020

Italian Study Evaluates Changes in Hospital Admissions for STEMI Caused by COVID-19 Pandemic

August 14, 2020—Preliminary results from a cardiovascular regional public service health care hub in Italy demonstrated a significantly longer time from symptoms onset to hospital admission among patients with ST-segment elevation myocardial infarction (STEMI) during the COVID-19 pandemic compared with the same time period in the previous 2 years. Mario Gramegna, MD, et al published the findings online in Circulation: Cardiovascular Interventions.

The study investigators, who are from IRCCS San Raffaele Scientific Institute in Milan, Italy, aimed to assess clinical features of patients with STEMI during the COVID-19 pandemic.

This single-center, prospective study included all consecutive patients with STEMI admitted to the institute from February 21 to April 1, 2020. These patients were compared with a historical cohort of patients admitted for STEMI during the analogous time period (February 21 to April 1) in 2018 and 2019, in terms of time from symptoms onset to hospital admission, clinical characteristics, and in-hospital outcomes.

As summarized in Circulation: Cardiovascular Interventions, the study was composed of 26 patients admitted for STEMI during the study period; seven (26.9%) of these patients tested positive for COVID-19.

On admission, medical therapy, including angiotensin-converting enzyme inhibitors and angiotensin receptor blockers use, was similar between cohorts. Median (interquartile range) time from symptoms onset to hospital admission was significantly longer in 2020 as compared with the historical cohort (15 [2-48] vs 2 [1-3] hours; P < .01). A higher proportion of patients with late presentation STEMI was observed in 2020 compared with the historical cohort (50% vs 4.8%; P < .01). Primary percutaneous coronary intervention was indicated in 80.8% of patients in 2020 compared with 100% in the historical cohort (P = .06).

In-hospital death, thromboembolism, mechanical ventilation, or hemodynamic decompensation requiring inotropic or mechanical support were similar between years, reported the investigators in Circulation: Cardiovascular Interventions.

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