Impact of the shift to a fibrinolysis-first strategy on care and outcomes of patients with ST-segment–elevation myocardial infarction during the COVID-19 pandemic—The experience from the largest cardiovascular-specific centre in China

The impact of fibrinolysis-first strategy on outcomes of patients with ST-segment-elevation myocardial infarction (STEMI) during the COVID-19 pandemic was unknown. Data from STEMI patients presenting to Fuwai Hospital from January 23 to April 30, 2020 were compared with those during the equivalent p...

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Published in:International journal of cardiology 2021-04, Vol.329, p.260-265
Main Authors: Leng, Wen-Xiu, Yang, Jin-Gang, Li, Xiang-Dong, Jiang, Wen-Yang, Gao, Li-Jian, Wu, Yuan, Yang, Yan-Min, Yuan, Jin-Qing, Yang, Wei-Xian, Qiao, Shu-Bin, Yang, Yue-Jin
Format: Article
Language:English
Subjects:
China - epidemiology
Comorbidity
COVID-19
COVID-19 - epidemiology
Female
Fibrinolysis
Fibrinolytic Agents - therapeutic use
Follow-Up Studies
Humans
Male
Middle Aged
Net adverse clinical events
Pandemics
Practice Guidelines as Topic
Primary percutaneous intervention
Registries
Retrospective Studies
SARS-CoV-2
ST Elevation Myocardial Infarction - epidemiology
ST Elevation Myocardial Infarction - therapy
ST-segment-elevation myocardial infarction
Thrombolytic Therapy - methods
Treatment Outcome
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Summary:The impact of fibrinolysis-first strategy on outcomes of patients with ST-segment-elevation myocardial infarction (STEMI) during the COVID-19 pandemic was unknown. Data from STEMI patients presenting to Fuwai Hospital from January 23 to April 30, 2020 were compared with those during the equivalent period in 2019. The primary end-point was net adverse clinical events (NACE; a composite of death, non-fatal myocardial reinfarction, stroke, emergency revascularization, and bleeding over BARC type 3). The secondary outcome was a composite of recurrent ischaemia, cardiogenic shock, and exacerbated heart failure. The final analysis included 164 acute STEMI patients from 2020 and 240 from 2019. Eighteen patients (20.2% of those with indications) received fibrinolysis therapy in 2020 with a median door-to-needle time of 60.0 (43.5, 92.0) minutes. Patients in 2020 underwent primary PCI less frequently than their counterparts (14 [14.2%] vs. 144 [86.8%] in 2019, P 
ISSN:0167-5273
1874-1754
DOI:10.1016/j.ijcard.2020.11.074