Int J Angiol 2021; 30(02): 148-154
DOI: 10.1055/s-0041-1727133
Original Article

Performance of Primary Angioplasty for STEMI during the COVID-19 Outbreak

Authors

  • Surya Dharma

    1   Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Indonesia, Indonesian Cardiovascular Research Center, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
  • Iwan Dakota

    2   Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Indonesia, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
  • Isman Firdaus

    2   Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Indonesia, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
  • Siska Suridanda Danny

    2   Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Indonesia, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
  • Dian Zamroni

    2   Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Indonesia, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
  • Ardi Yudha

    3   Indonesian Cardiovascular Research Center, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
  • Agus Susanto

    4   Catheterization Laboratory Nurse Manager, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
  • Bambang Budi Siswanto

    2   Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Indonesia, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia

Funding No external funding support.
Preview

Abstract

There has been concern whether the declining cases of ST-segment elevation myocardial infarction (STEMI) during the coronavirus disease 2019 (COVID-19) outbreak associate with primary angioplasty performance.

We assessed the performance of primary angioplasty in a tertiary care hospital in Jakarta, Indonesia, by comparing the door-to-device (DTD) time and thrombolysis in myocardial infarction (TIMI) flow after angioplasty between two periods of admission: during the outbreak of COVID-19 (March 1 to May 31, 2020) and before the outbreak (March 1, to May 31, 2019).

Overall, there was a relative reduction of 44% for STEMI admission during the outbreak (n = 116) compared with before the outbreak (N = 208). Compared with before the outbreak period (n = 141), STEMI patients who admitted during the outbreak and received primary angioplasty (n = 70) had similar median symptom onset-to-angioplasty center admission (360 minutes for each group), similar to radial access uptake (90 vs. 89.4%, p = 0.88) and left anterior descending infarct-related artery (54.3 vs. 58.9%, p = 0.52). The median DTD time and total ischemia time were longer (104 vs. 81 minutes, p < 0.001, and 475.5 vs. 449 minutes, p = 0.43, respectively). However, the final achievement of TIMI 3 flow was similar (87.1 vs. 87.2%), and so was the in-hospital mortality (5.7 vs. 7.8%).

During the COVID-19 outbreak, we found a longer DTD time for primary angioplasty, but the achievement of final TIMI 3 flow and in-hospital mortality were similar as compared with before the outbreak. Thus, primary angioplasty should remain the standard of care for STEMI during the COVID-19 outbreak.

Note

There was no external funding to support this study, and this study has no relationship with any industrial company.


Disclosures

Nothing to declare.




Publication History

Article published online:
20 April 2021

© 2021. International College of Angiology. This article is published by Thieme.

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  • References

  • 1 De Filippo O, D'Ascenzo F, Angelini F. et al. Reduced rate of hospital admissions for ACS during Covid-19 outbreak in Northern Italy. N Engl J Med 2020; 383 (01) 88-89
  • 2 Metzler B, Siostrzonek P, Binder RK, Bauer A, Reinstadler SJ. Decline of acute coronary syndrome admissions in Austria since the outbreak of COVID-19: the pandemic response causes cardiac collateral damage. Eur Heart J 2020; 41 (19) 1852-1853
  • 3 Dharma S, Andriantoro H, Purnawan I. et al. Characteristics, treatment and in-hospital outcomes of patients with STEMI in a metropolitan area of a developing country: an initial report of the extended Jakarta Acute Coronary Syndrome registry. BMJ Open 2016; 6 (08) e012193
  • 4 Dharma S, Andriantoro H, Dakota I. et al. Organisation of reperfusion therapy for STEMI in a developing country. Open Heart 2015; 2 (01) e000240
  • 5 Dharma S, Siswanto BB, Firdaus I. et al. Temporal trends of system of care for STEMI: insights from the Jakarta Cardiovascular Care Unit Network System. PLoS One 2014; 9 (02) e86665
  • 6 Dharma S, Sari NY, Santoso A, Sukmawan R, Rao SV. Association of plasma pentraxin 3 concentration with angiographic and clinical outcomes in patients with acute ST-segment elevation myocardial infarction treated by primary angioplasty. Catheter Cardiovasc Interv 2020; 96 (06) 1233-1239
  • 7 Central Bureau of Statistics - Indonesia. 2016 statistics
  • 8 Jakarta Tanggap COVID-19. Dinas Kesehatan DKI Jakarta. ; [cited 2020 April 27]. Accessed March 11, 2021 from: https://corona.jakarta.go.id/id
  • 9 Ibanez B, James S, Agewall S. et al; ESC Scientific Document Group. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J 2018; 39 (02) 119-177
  • 10 O'Gara PT, Kushner FG, Ascheim DD. et al; CF/AHA Task Force. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation 2013; 127 (04) 529-555
  • 11 Zeng J, Huang J, Pan L. How to balance acute myocardial infarction and COVID-19: the protocols from Sichuan Provincial People's Hospital. Intensive Care Med 2020; 46 (06) 1111-1113
  • 12 Keeley EC, Boura JA, Grines CL. Primary angioplasty versus intravenous thrombolytic therapy for acute myocardial infarction: a quantitative review of 23 randomised trials. Lancet 2003; 361 (9351): 13-20
  • 13 Mahmud E, Dauerman HL, Welt FGP. et al. Management of acute myocardial infarction during the COVID-19 pandemic: a position statement from the Society for Cardiovascular Angiography and Interventions (SCAI), the American College of Cardiology (ACC), and the American College of Emergency Physicians (ACEP). J Am Coll Cardiol 2020; 76 (11) 1375-1384