PMID- 34344723
OWN - NLM
STAT- MEDLINE
DCOM- 20210811
LR  - 20210811
IS  - 2053-3624 (Print)
IS  - 2053-3624 (Electronic)
IS  - 2053-3624 (Linking)
VI  - 8
IP  - 2
DP  - 2021 Aug
TI  - Review of Irish patients meeting ST elevation criteria during the COVID-19 
      pandemic.
LID - 10.1136/openhrt-2021-001716 [doi]
LID - e001716
AB  - INTRODUCTION: The COVID-19 pandemic has seen the introduction of important public 
      health measures to minimise the spread of the virus. We aim to identify the 
      impact government restrictions and hospital-based infection control procedures on 
      ST elevation myocardial infarction (STEMI) care during the COVID-19 pandemic. 
      METHODS: Patients meeting ST elevation criteria and undergoing primary 
      percutaneous coronary intervention from 27 March 2020, the day initial national 
      lockdown measures were announced in Ireland, were included in the study. Patients 
      presenting after the lockdown period, from 18 May to 31 June 2020, were also 
      examined. Time from symptom onset to first medical contact (FMC), transfer time 
      and time of wire cross was noted. Additionally, patient characteristics, left 
      ventricular ejection fraction, mortality and biochemical parameters were 
      documented. Outcomes and characteristics were compared against a control group of 
      patients meeting ST elevation criteria during the month of January. RESULTS: A 
      total of 42 patients presented with STEMI during the lockdown period. A 
      significant increase in total ischaemic time (TIT) was noted versus controls 
      (8.81 hours (+/-16.4) vs 2.99 hours (+/-1.39), p=0.03), with increases driven largely 
      by delays in seeking FMC (7.13 hours (+/-16.4) vs 1.98 hours (+/-1.46), p=0.049). TIT 
      remained significantly elevated during the postlockdown period (6.1 hours (+/-5.3), 
      p=0.05), however, an improvement in patient delays was seen versus the control 
      group (3.99 hours (+/-4.5), p=0.06). There was no difference seen in transfer times 
      and door to wire cross time during lockdown, however, a significant increase in 
      transfer times was seen postlockdown versus controls (1.81 hours (+/-1.0) vs 
      1.1 hours (+/-0.87), p=0.004). CONCLUSION: A significant increase in TIT was seen 
      during the lockdown period driven mainly by patient factors highlighting the 
      significance of public health messages on public perception. Additionally, a 
      significant delay in transfer times to our centre was seen postlockdown.
CI  - (c) Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No 
      commercial re-use. See rights and permissions. Published by BMJ.
FAU - Byrne, Luke
AU  - Byrne L
AUID- ORCID: 0000-0002-7389-4979
AD  - Department of Cardiology, Saint James's Hospital, Dublin, Ireland lubyrne@tcd.ie.
FAU - Gardiner, Roisin
AU  - Gardiner R
AD  - Department of Cardiology, Saint James's Hospital, Dublin, Ireland.
FAU - Devitt, Patrick
AU  - Devitt P
AD  - Department of Cardiology, Saint James's Hospital, Dublin, Ireland.
FAU - Powell, Caleb
AU  - Powell C
AD  - Department of Cardiology, Saint James's Hospital, Dublin, Ireland.
FAU - Armstrong, Richard
AU  - Armstrong R
AD  - Department of Cardiology, Saint James's Hospital, Dublin, Ireland.
FAU - Teehan, Sinead
AU  - Teehan S
AD  - Department of Cardiology, Saint James's Hospital, Dublin, Ireland.
FAU - O'Connor, Stephen
AU  - O'Connor S
AD  - Department of Cardiology, Saint James's Hospital, Dublin, Ireland.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Observational Study
PL  - England
TA  - Open Heart
JT  - Open heart
JID - 101631219
SB  - IM
MH  - Aged
MH  - *COVID-19
MH  - Databases, Factual
MH  - Female
MH  - Humans
MH  - Infection Control/trends
MH  - Ireland
MH  - Male
MH  - Middle Aged
MH  - Outcome and Process Assessment, Health Care/*trends
MH  - Patient Acceptance of Health Care
MH  - Patient Transfer/trends
MH  - Percutaneous Coronary Intervention/adverse effects/mortality/*trends
MH  - Retrospective Studies
MH  - ST Elevation Myocardial Infarction/diagnostic imaging/mortality/*therapy
MH  - Time Factors
MH  - Time-to-Treatment/trends
MH  - Treatment Outcome
PMC - PMC8338315
OTO - NOTNLM
OT  - COVID-19
OT  - cardiac catheterization
OT  - delivery of health care
OT  - global burden of disease
OT  - myocardial infarction
COIS- Competing interests: None declared.
EDAT- 2021/08/05 06:00
MHDA- 2021/08/12 06:00
PMCR- 2021/08/03
CRDT- 2021/08/04 06:19
PHST- 2021/05/09 00:00 [received]
PHST- 2021/07/13 00:00 [accepted]
PHST- 2021/08/04 06:19 [entrez]
PHST- 2021/08/05 06:00 [pubmed]
PHST- 2021/08/12 06:00 [medline]
PHST- 2021/08/03 00:00 [pmc-release]
AID - openhrt-2021-001716 [pii]
AID - 10.1136/openhrt-2021-001716 [doi]
PST - ppublish
SO  - Open Heart. 2021 Aug;8(2):e001716. doi: 10.1136/openhrt-2021-001716.