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Introduction and objectives The COVID-19 outbreak has had an unclear impact on the treatment and outcomes of patients with ST-segment elevation myocardial infarction (STEMI). The aim of this study was to assess changes in STEMI management during the COVID-19 outbreak. Methods Using a multicenter, nationwide, retrospective, observational registry of consecutive patients who were managed in 75 specific STEMI care centers in Spain, we compared patient and procedural characteristics and in-hospital outcomes in 2 different cohorts with 30-day follow-up according to whether the patients had been treated before or after COVID-19. Results Suspected STEMI patients treated in STEMI networks decreased by 27.6% and patients with confirmed STEMI fell from 1305 to 1009 (22.7%). There were no differences in reperfusion strategy (> 94% treated with primary percutaneous coronary intervention in both cohorts). Patients treated with primary percutaneous coronary intervention during the COVID-19 outbreak had a longer ischemic time (233 [150-375] vs 200 [140-332] minutes, P

The aim of this study is to propose national diagnostic reference levels (DRL) for updating in the field of interventional cardiology and to include technical details to help plan optimization. Medical physics experts and interventional cardiologists from 14 hospitals provided patient dose indicators from coronary angiography and percutaneous coronary interventions. Information about X-ray system dose settings and image quality was also provided. The dose values from 30,024 procedures and 26 interventional laboratories were recorded. The national DRLs proposed for coronary angiography and percutaneous coronary interventions were respectively 39 and 78 Gy·cm2 for air kerma area product (PKA), 530 and 1300 mGy for air kerma at reference point (Ka,r), 6.7 and 15 min of fluoroscopy time and 760 and 1300 cine images. 36% of the KAP meters required correction factors from 10 to 35%. The dose management systems should allow these corrections to be included automatically. The dose per image in cine in reference conditions differed in a factor of 5.5. Including X-ray system dose settings in the methodology provides an insight into the differences between hospitals. The DRLs proposed for Spain in this work were similar to those proposed in the last European survey. The poor correlation between X-ray systems dose settings and patient dose indicators highlights that other factors such as operation protocols and complexity may have more impact in patient dose indicators, which allows a wide margin for optimization. Dose reduction technology together with appropriate training programs will be determinant in the future reduction of patient dose indicators.

OBJECTIVES There is a wealth of published data on blood pressure (BP) and physical activity in adults of European descent, but less information is available for Amerindian schoolchildren. The aim of this study was to investigate whether BP and other cardiometabolic risk factors differ by physical activity levels in schoolchildren from different ethnic backgrounds. METHODS This was a cross-sectional study of 540 schoolchildren (6-13 years) from two ethnic backgrounds (n = 119 Mapuche Amerindians and n = 421 of European descent). Physical activity was measured using international physical activity recommendations and a standard questionnaire, and ethnicity was classified according to previous methods using surnames. The population was divided into the following four groups: (a) physically active Mapuches (n = 45) and of European descent (n = 101); and (b) physically inactive Mapuches (n = 74) and of European descent (n = 320). RESULTS In physically inactive schoolchildren, significant differences were found between schoolchildren of Mapuche and European descent in systolic (134 ± 3 mmHg vs 130 ± 5 mmHg, respectively, P = .034) and diastolic BP (85 ± 13 mmHg vs 81 ± 3 mmHg, P = .029). For other cardiometabolic risk factors, schoolchildren with Mapuche surnames were significantly less likely to be classified with normal weight (5 [6.8%] vs 85 [26.6%]), and more likely to be obese (30 [40.5%] vs 76 [26.6%]) at P