Author + information
- Received May 3, 2020
- Revision received June 17, 2020
- Accepted June 18, 2020
- Published online September 7, 2020.
- Dingcheng Xiang, MDa,∗∗ (, )
- Xin Xiang, PhDb,∗,
- Wei Zhang, PhDc,
- Shaodong Yi, MDa,
- Jinxia Zhang, MDa,
- Xiaolong Gu, MDa,
- Yawei Xu, MDd,
- Kai Huang, MDe,
- Xi Su, MDf,
- Bo Yu, MDg,
- Yan Wang, MDh,
- Weiyi Fang, MDi,
- Yong Huo, MDj,∗∗ ( and )
- Junbo Ge, MDk
- aDepartment of Cardiology, General Hospital of Southern Theatre Command of PLA, Guangzhou, China
- bGraduate School of Arts and Sciences, Harvard University, Cambridge, Massachusetts
- cDepartment of Biostatistics, School of Public Health, Fudan University, Shanghai, China
- dDepartment of Cardiology, 10th Hospital of Tongji University, Shanghai, China
- eDepartment of Cardiology, Union Hospital of Huazhong University of Science and Technology, Wuhan, China
- fDepartment of Cardiology, Wuhan Asia Heart Hospital, Wuhan, China
- gDepartment of Cardiology, Key Laboratories of Education Ministry for Myocardial Ischemia Mechanism and Treatment, 2nd Affiliated Hospital of Harbin Medical University, Harbin, China
- hDepartment of Cardiology, Xiamen Heart Center, Xiamen, China
- iDepartment of Cardiology, Shanghai Dongfang Hospital, Shanghai, China
- jDepartment of Cardiology, Peking University First Hospital, Beijing, China
- kDepartment of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, China
Background ST-segment elevation myocardial infarction (STEMI) is a fatal cardiovascular emergency requiring rapid reperfusion treatment. During the coronavirus disease-2019 (COVID-19) pandemic, medical professionals need to strike a balance between providing timely treatment for STEMI patients and implementing infection control procedures to prevent nosocomial spread of COVID-19 among health care workers and other vulnerable cardiovascular patients.
Objectives This study evaluates the impact of the COVID-19 outbreak and China Chest Pain Center’s modified STEMI protocol on the treatment and prognosis of STEMI patients in China.
Methods Based on the data of 28,189 STEMI patients admitted to 1,372 Chest Pain Centers in China between December 27, 2019 and February 20, 2020, the study analyzed how the COVID-19 outbreak and China Chest Pain Center’s modified STEMI protocol influenced the number of admitted STEMI cases, reperfusion strategy, key treatment time points, and in-hospital mortality and heart failure for STEMI patients.
Results The COVID-19 outbreak reduced the number of STEMI cases reported to China Chest Pain Centers. Consistent with China Chest Pain Center’s modified STEMI protocol, the percentage of patients undergoing primary percutaneous coronary intervention declined while the percentage of patients undergoing thrombolysis increased. With an average delay of approximately 20 min for reperfusion therapy, the rate of in-hospital mortality and in-hospital heart failure increased during the outbreak, but the rate of in-hospital hemorrhage remained stable.
Conclusions There were reductions in STEMI patients’ access to care, delays in treatment timelines, changes in reperfusion strategies, and an increase of in-hospital mortality and heart failure during the COVID-19 pandemic in China.
- chest pain center
- primary percutaneous coronary intervention
- ST-segment elevation myocardial infarction
↵∗ Drs. Dingcheng Xiang and Xin Xiang contributed equally to this work.
This study is supported by Ministry of Science and Technology of the People’s Republic of China (2016YFC1301201). The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
The authors attest they are in compliance with human studies committees and animal welfare regulations of the authors’ institutions and Food and Drug Administration guidelines, including patient consent where appropriate. For more information, visit the JACC author instructions page.
- Received May 3, 2020.
- Revision received June 17, 2020.
- Accepted June 18, 2020.
- 2020 The Authors