STEMI care in the wake of COVID-19: 3 research teams share their findings
COVID-19 has disrupted routine cardiovascular care all over the world, with some procedures getting delayed for months and many hospitals reporting a significant drop in myocardial infarction (MI) patients. When it comes to ST-elevation myocardial infarction (STEMI) care, however, the pandemic has hit different areas in different ways.
One analysis in the Journal of the American College of Cardiology, for instance, estimated that COVID-19 resulted in a 38% reduction in STEMI activations in the United States. The authors based their findings on data from nine different “high-volume” cardiac cath labs, including providers in Minnesota, Michigan, Ohio, Massachusetts, Iowa, New York, Illinois and Washington.
“Potential etiologies for the decrease in STEMI PPCI activations include avoidance of medical care due to social distancing or concerns of contracting COVID-19 in the hospital, STEMI misdiagnosis, and increased use of pharmacological reperfusion due to COVID-19,” wrote lead author Santiago Garcia, MD, Minneapolis Heart Institute, and colleagues. “As the pandemic continues, we plan to continue to follow this early signal and investigate its causes.”
Two recent assessments published in the American Journal of Cardiology, however, painted a different picture. In the first, lead author Yi-Heng Li, MD, PhD, and colleagues from the Taiwan Society of Cardiology surveyed 42 Taiwanese hospitals with 24-hour percutaneous coronary intervention (PCI) service and reported “no reduction of STEMI admission.” Care was delayed, however, and the authors wrote that “further actions are necessary to avoid the negative impact of COVID-19” on STEMI care.
In the second assessment, a team of researchers from Baystate Medical Center in Springfield, Massachusetts, tracked STEMI data from a “high-volume STEMI center in the Commonwealth of Massachusetts, with high volumes of reported COVID-19 cases. The authors reported seeing “no significant change in STEMI volume”—though, they explained, they did conduct their study differently than the team from the Minneapolis Heart Institute, looking at STEMI volume instead of STEMI activations.
“STEMI activations during the COVID-19 pandemic could be reduced due to the fact that emergency department personnel, due to concerns for infection, may consult interventional cardiology directly rather than activate the cardiac catheterization laboratory in order to limit exposure and decrease false activation,” wrote lead author Amir S Lotfi, MD, and colleagues.
Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.