Author + information
- Published online April 20, 2020.
- Ehtisham Mahmud, MD FACC FSCAI1,ˆ∗ (, )
- Harold L. Dauerman, MD FACC FSCAI2,
- Frederick GP. Welt, MD FACC FSCAI3,§,
- John C. Messenger, MD FACC FSCAI4,∗,
- Sunil V. Rao, MD FACC FSCAI5,∗,
- Cindy Grines, MD FACC MSCAI6,∗,
- Amal Mattu, MD FACEP7,‡,
- Ajay J. Kirtane, MD SM FACC FSCAI8,§,
- Rajiv Jauhar, MD FACC FSCAI9,
- Perwaiz Meraj, MD FACC FSCAI10,
- Ivan C. Rokos, MD FACEP11,
- John S. Rumsfeld, MD PhD FACC12,§ and
- Timothy D. Henry, MD FACC MSCAI13,∗,§
- 1University of California, San Diego, Sulpizio Cardiovascular Center, La Jolla, CA
- 2University of Vermont, Burlington, VT
- 3University of Utah Medical Center, Salt Lake City, UT
- 4University of Colorado School of Medicine, Aurora, CO
- 5Duke University Hospital, Durham, NC
- 6Northside Cardiovascular Institute, Atlanta, GA
- 7University of Maryland School of Medicine, Baltimore, MD
- 8Columbia University Medical Center, Center for Interventional Vascular Therapy, New York, NY
- 9Northwell Health, Manhasset, NY
- 10Hofstra North Shore – LIJ School of Medicine, Manhasset, NY
- 11Methodist Hospital of Southern California, Arcadia, CA
- 12University of Colorado Medical School, Denver, CO
- 13The Carl and Edyth Lindner Center for Research and Education, The Christ Hospital, Cincinnati, OH
- ↵ˆAddress for Correspondence: Ehtisham Mahmud, MD, FACC, FSCAI Professor and Division Chief, Cardiovascular Medicine University of California, San Diego 9434 Medical Center Drive, La Jolla, CA 92037 Ph: (858) 657-8030
The worldwide pandemic caused by the novel acute respiratory syndrome coronavirus 2 (SARS-CoV2) has resulted in a new and lethal disease termed coronavirus disease 2019 (COVID-19). Although there is an association between cardiovascular disease and COVID-19, the majority of patients who need cardiovascular care for the management of ischemic heart disease may not be infected with COVID-19. The objective of this document is to provide recommendations for a systematic approach for the care of patients with an acute myocardial infarction (AMI) during the COVID-19 pandemic. There is a recognition of two major challenges in providing recommendations for AMI care in the COVID-19 era. Cardiovascular manifestations of COVID-19 are complex with patients presenting with AMI, myocarditis simulating a ST-elevation MI presentation, stress cardiomyopathy, non-ischemic cardiomyopathy, coronary spasm, or nonspecific myocardial injury and the prevalence of COVID-19 disease in the US population remains unknown with risk of asymptomatic spread. This document addresses the care of these patients focusing on 1) the varied clinical presentations; 2) appropriate personal protection equipment (PPE) for health care workers; 3) role of the Emergency Department, Emergency Medical System and the Cardiac Catheterization Laboratory; and 4) Regional STEMI systems of care. During the COVID-19 pandemic, primary PCI remains the standard of care for STEMI patients at PCI capable hospitals when it can be provided in a timely fashion, with an expert team outfitted with PPE in a dedicated CCL room. A fibrinolysis-based strategy may be entertained at non-PCI capable referral hospitals or in specific situations where primary PCI cannot be executed or is not deemed the best option.
- acute myocardial infarction
- emergency medical system
- percutaneous coronary intervention
↵§ Representative of the American College of Cardiology
↵‡ Representative of the American College of Emergency Physicians
↵∗ Representative of the Society of Cardiovascular Angiography & Interventions
A Consensus Statement from the Society for Cardiovascular Angiography and Interventions (SCAI), American College of Cardiology (ACC), and the American College of Emergency Physicians (ACEP)
EM reports clinical trial research support (Corindus, Abbott Vascular, CSI), consulting (Medtronic), consulting and equity (Abiomed). HLD reports research grants and consulting (Boston Scientific and Medtronic). FGPW reports clinical trial support (Medtronic) and advisory board (Medtronic). JCM and SVR report no relevant disclosures. CG reports advisory board (Phillips and Abiomed). AM reports no relevant disclosures. AJK reports Institutional funding to Columbia University and/or Cardiovascular Research Foundation from Medtronic, Boston Scientific, Abbott Vascular, Abiomed, CSI, Philips, ReCor Medical. Personal: CME/conference honoraria and travel/meals only. RJ reports no relevant disclosure, PM reports research and educational grants (Abiomed, Medtronic), ICR, JR and TDH report no relevant disclosures.
This document was endorsed by the American College of Cardiology (ACC), the American College of Emergency Physicians (ACEP), and the Society for Cardiovascular Angiography & Interventions (SCAI) in April 2020.
© 2020 by the American College of Cardiology Foundation and Wiley Periodicals, Inc.
This article has been copublished in Catheterization and Cardiovascular Interventions and the Journal of the American College of Cardiology.
- 2020 American College of Cardiology Foundation