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Primary PCI: a reasonable treatment for STEMI care during the COVID-19 pandemic

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Abstract Funding Acknowledgements Type of funding sources: None. Introduction Controversy remains about the best strategy for STEMI reperfusion during the COVID-19 pandemic. There are no uniform criteria in this setting and it has been proposed that fibrinolysis may be the strategy of choice during lockdown. The aim is to present our experience and safety in maintaining the guidelines based STEMI reperfusion strategy. Methods and purpose   Retrospective study comparing patients treated for STEMI during the period of lockdown in Spain (03/15/2020 to 05/31/2020) and patients with STEMI treated in the same period of the previous year (2019). Result We included 73 patients from the pre-COVID period versus 67 patients from the lockdown. Baseline characteristics  are showed in table 1. There were no significant differences neither in the choice of reperfusion strategy (fibrinolysis or primary percutaneous coronary intervention) nor in the occurrence of complications. Independently of the reperfusion strategy, there was not a significant increase on reperfusion times (table 1). There were no significant differences in complications during admission. In our experience, PPCI achieved similar in-hospital and 30-day mortality, as compared with fibrinolysis during the COVID-19 lockdown (Image 1). There was not any case of SARS-CoV2 infection among cath lab staff. Conclusions To use conventional guidelines based reperfusion strategy of STEMI patients is a safe and effective strategy during the COVID-19 lockdown. Table 1Pre-Covid (n = 73)Lockdown COVID-19 (n = 67)p valueSex male; n (%)55 (75,3)49 (73,1)0,76Age yr66 +/- 1365 +/- 150,92Hypertension; n (%)40 (54,8)42 (62,7)0,34Diabetes; n (%)24 (32,9)10 (14,9)0,013*Hypercholesterolemia; n (%)39 (53,4)33 (49,2)0,62Smoker; n (%)26 (35,6)25 (37,3)0,83Previous MI; n (%)12 (16,4)9 (13,4)0,62Reperfusion strategy, n (%)Fibrinolysis5 (6,8) /* Font Definitions */ @font-face {font-family:Calibri; panose-1:2 15 5 2 2 2 4 3 2 4; mso-font-charset:0; mso-generic-font-family:swiss; mso-font-pitch:variable; mso-font-signature:-469750017 -1073732485 9 0 511 0;} /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {mso-style-unhide:no; mso-style-qformat:yes; mso-style-parent:""; margin-top:0cm; margin-right:0cm; margin-bottom:8.0pt; margin-left:0cm; line-height:107%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri",sans-serif; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:Calibri; mso-fareast-theme-font:minor-latin; 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Image 1
Title: Primary PCI: a reasonable treatment for STEMI care during the COVID-19 pandemic
Description:
Abstract Funding Acknowledgements Type of funding sources: None.
Introduction Controversy remains about the best strategy for STEMI reperfusion during the COVID-19 pandemic.
There are no uniform criteria in this setting and it has been proposed that fibrinolysis may be the strategy of choice during lockdown.
The aim is to present our experience and safety in maintaining the guidelines based STEMI reperfusion strategy.
Methods and purpose   Retrospective study comparing patients treated for STEMI during the period of lockdown in Spain (03/15/2020 to 05/31/2020) and patients with STEMI treated in the same period of the previous year (2019).
Result We included 73 patients from the pre-COVID period versus 67 patients from the lockdown.
Baseline characteristics  are showed in table 1.
There were no significant differences neither in the choice of reperfusion strategy (fibrinolysis or primary percutaneous coronary intervention) nor in the occurrence of complications.
Independently of the reperfusion strategy, there was not a significant increase on reperfusion times (table 1).
There were no significant differences in complications during admission.
In our experience, PPCI achieved similar in-hospital and 30-day mortality, as compared with fibrinolysis during the COVID-19 lockdown (Image 1).
There was not any case of SARS-CoV2 infection among cath lab staff.
Conclusions To use conventional guidelines based reperfusion strategy of STEMI patients is a safe and effective strategy during the COVID-19 lockdown.
Table 1Pre-Covid (n = 73)Lockdown COVID-19 (n = 67)p valueSex male; n (%)55 (75,3)49 (73,1)0,76Age yr66 +/- 1365 +/- 150,92Hypertension; n (%)40 (54,8)42 (62,7)0,34Diabetes; n (%)24 (32,9)10 (14,9)0,013*Hypercholesterolemia; n (%)39 (53,4)33 (49,2)0,62Smoker; n (%)26 (35,6)25 (37,3)0,83Previous MI; n (%)12 (16,4)9 (13,4)0,62Reperfusion strategy, n (%)Fibrinolysis5 (6,8) /* Font Definitions */ @font-face {font-family:Calibri; panose-1:2 15 5 2 2 2 4 3 2 4; mso-font-charset:0; mso-generic-font-family:swiss; mso-font-pitch:variable; mso-font-signature:-469750017 -1073732485 9 0 511 0;} /* Style Definitions */ p.
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Image 1.

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