- 著者
- Nicholas WS Chew Ching-Hui Sia Hwee-Lin Wee Loh Jia-Da Benedict Saurabh Rastogi Pipin Kojodjojo Wei Ping Daniel Chor Benjamin Sieu-Hon Leong Brandon Chi-Ping Koh Howen Tam Lit-Sin Quek Winnie CH Sia Kalyar Win Saw Benjamin Wei-Liang Tung Zan Zhe-Yan Ng Anand Ambhore Edgar Lik-Wui Tay Koo-Hui Chan Chi-Hang Lee Joshua Ping-Yun Loh Adrian Fatt-Hoe Low Mark Yan-Yee Chan Tiong-Cheng Yeo Huay-Cheem Tan Poay-Huan Loh
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- pp.CJ-20-0800, (Released:2020-11-07)
- 参考文献数
- 26
- 被引用文献数
- 45
Background:Little is known about the effect of the coronavirus disease 2019 (COVID-19) pandemic and the outbreak response measures on door-to-balloon time (D2B). This study examined both D2B and clinical outcomes of patients with STEMI undergoing primary percutaneous coronary intervention (PPCI).Methods and Results:This was a retrospective study of 303 STEMI patients who presented directly or were transferred to a tertiary hospital in Singapore for PPCI from October 2019 to March 2020. We compared the clinical outcomes of patients admitted before (BOR) and during (DOR) the COVID-19 outbreak response. The study outcomes were in-hospital death, D2B, cardiogenic shock and 30-day readmission. For direct presentations, fewer patients in the DOR group achieved D2B time <90 min compared with the BOR group (71.4% vs. 80.9%, P=0.042). This was more apparent after exclusion of non-system delay cases (DOR 81.6% vs. BOR 95.9%, P=0.006). Prevalence of both out-of-hospital cardiac arrest (9.5% vs. 1.9%, P=0.003) and acute mitral regurgitation (31.6% vs. 17.5%, P=0.006) was higher in the DOR group. Mortality was similar between groups. Multivariable regression showed that longer D2B time was an independent predictor of death (odds ratio 1.005, 95% confidence interval 1.000–1.011, P=0.029).Conclusions:The COVID-19 pandemic and the outbreak response have had an adverse effect on PPCI service efficiency. The study reinforces the need to focus efforts on shortening D2B time, while maintaining infection control measures.