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52. THE PROTOCOL: INFLUENCE OF THE COMBINATION CARRIAGE СУР2С19*2 AND *17 ON EFFICACY OF CLOPIDOGREL

Author

Zelenskaya, Е. М., primary, Barbarash, О. L., additional, Ganyukov, V. I., additional, Kochergin, N. A., additional, Apartsin, К. A., additional, Gorokhova, А. V., additional, Papeshina, S. А., additional, Nikolaev, К. Yu., additional, Batueva, К. Yu., additional, Yankovskaya, S. V., additional, Tronin, А. V., additional, and Lifshits, G. I., additional

Published
2017
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54. Prospective rAndomized, single-blind, mulTicenter control clinical study of sirolimus-eluting coRonary stent “Calypso” vs everolimus-elutIng cOronary stenT “Xience Prime”: design and rationale for “PATRIOT” trial

Author

Prokhorikhin, A. A., primary, Verin, V. V., additional, Osiev, A. G., additional, Ganyukov, V. I., additional, Protopopov, A. V., additional, Dyomin, V. V., additional, Abugov, S. A., additional, Baystrukov, V. I., additional, Grazhdankin, I. O., additional, Ponomaryov, D. N., additional, and Kretov, E. I., additional

Published
2016
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68. THE “PROTOCOL” STUDY: PRELIMINARY RESULTS

Author

Zelenskaya, E. M., primary, Subbotovskaya, A. I., additional, Ganyukov, V. I., additional, Kochergin, N. A., additional, Barbarich, V. B., additional, Saraeva, N. O., additional, Vybivantseva, A. V., additional, Apartsin, K. A., additional, and Lifshitz, G. I., additional

Published
2015
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75. Experimental Model of Rat Aorta Angioplasty with a Paclitaxel Releasing Balloon Catheter.

Author

Sin'kov, M., Filip'ev, D., Sevost'yanova, V., Velikanova, E., Burago, A., and Ganyukov, V.

Subjects
TRANSLUMINAL angioplasty, CATHETERS, AORTA surgery, LABORATORY rats, PACLITAXEL
Abstract

We present an original and safe experimental model of the rat aorta angioplasty with a paclitaxel-releasing balloon catheter. No toxic effects of the drug on experimental animals were detected. [ABSTRACT FROM AUTHOR]

Published
2014
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76. Transcatheter correction of atrial septal defects in children of various age groups, its results, and effects on the right atrium remodelling

Author

Roman Tarasov, Kartashyan, E. S., Ganyukov, V. I., and Sizova, I. N.

Subjects
occluder implantation in children, RC666-701, right atrium remodelling, Diseases of the circulatory (Cardiovascular) system, transcatheter atrial septal defect closure
Abstract

Aim. The issue of safety and effectiveness of endovascular correction of atrial septal defects (ASD) in children aged 0–3 years remains controversial, due to a range of technical challenges and inadequate knowledge on the right atrium remodeling consequences in children across age groups. We analysed the in-hospital, 30-day, and long-term (12 months) outcomes of transcatheter correction of secundum ASD and occluder implantation in 89 children. Material and methods. All patients were divided into two groups: Group 1 (n=49) – younger children (mean age 1,7±0,6 years) who were operated before the age of 3; and Group 2 (n=40) – older children (mean age 6,2±3,2 years), who underwent the surgery after the age of 3. In both groups, no in-hospital or long-term (12 months) adverse effects, such as death, occluder migration, or the need for open surgery, were registered. Results. By Day 30 after the surgery, both groups demonstrated a consistent, significant reduction in mean size of right atrium, which persisted for the next 12 months (p

77. SYNTAX scale estimates of coronary stenosis severity and outcomes of various revascularisation strategies in patients with ST segment elevation myocardial infarction and multi-vessel coronary pathology

Author

Tarasov, R. S., Ganyukov, V. I., Shushpannikov, P. A., Krotikov, P. A., Barbarash, O. L., and Leonid Barbarash

Subjects
medicine.medical_specialty, business.industry, medicine.medical_treatment, primary pci, Percutaneous coronary intervention, Coronary stenosis, medicine.disease, myocardial infarction, surgical procedures, operative, syntax scale, RC666-701, Internal medicine, multi-vessel coronary pathology, Conventional PCI, medicine, Cardiology, Diseases of the circulatory (Cardiovascular) system, ST segment, In patient, cardiovascular diseases, Myocardial infarction, Cardiology and Cardiovascular Medicine, business
Abstract

Aim. To assess 30-day and long-term outcomes of various revascularisation strategies in patients with myocardial infarction and ST segment elevation (STEMI) and multi-vessel coronary pathology (MVCP), in regard to the severity of coronary stenosis, as assessed by the SYNTAX scale. Material and methods. The 30-day and long-term outcomes of various strategies of primary percutaneous coronary intervention (PCI) were assessed in 227 STEMI patients, in regard to the severity of their coronary stenosis (as assessed by the SYNTAX scale). Group 1 included 40 patients who underwent multi-vessel stenting (MVS) as a part of their primary PCI, while Group 2 included 187 patients with indications for staged revascularisation (SR). Results. At baseline, the MVS and SR subgroups with severe coronary stenosis (SYNTAX score

79. Prognosis in patients with ST segment elevation myocardial infarction, in regard to the presence of Type 2 diabetes mellitus and selected treatment strategy in the acute period

Author

Belen‘kova, Y. A., Tavlueva, E. V., Karetnikova, V. N., Mikhail Zykov, Kashtalap, V. V., Ganyukov, V. N., and Barbarash, O. L.

Subjects
surgical procedures, operative, myocardial infarction, RC666-701, diabetes mellitus, percutaneous coronary intervention, Diseases of the circulatory (Cardiovascular) system, cardiovascular diseases
Abstract

Aim. To assess the results of endovascular revascularisation in patients with acute myocardial infarction (AMI) and ST segment elevation (STEMI), in regard to the presence of Type 2 diabetes mellitus (DM-2), in the real-world clinical settings. Material and methods. The study included 423 STEMI patients, with or without concomitant DM-2. In the DM-2 group (n=77, 18,20%), percutaneous coronary intervention (PCI) was performed in 35 individuals (45,5%); in participants without DM-2, the respective figure was 54,91% (n=190). The follow-up period lasted for one year. The adverse long-term prognosis included repeated non-fatal MI and/or stroke, cardiac death, unstable angina, and decompensated heart failure (combined end-point). Results. In patients who underwent PCI, the presence of DM-2 did not affect substantially (p>0,05) the incidence of adverse clinical outcomes: it reached 28,57% (n=10) in participants with STEMI and DM-2 and 30,53% (n=58) in STEMI patients without DM-2. However, among individuals who did not undergo PCI, DM-2 was associated with increased incidence of the combined end-point: 52,38% (n=22) among those with STEMI and DM-2 vs. 42,95% (n=67) among those with STEMI only. Repeated interventions due to stent thrombosis (n=2; 5,71%) or stent restenosis (n=4; 11,43%) were non-significantly more frequent among patients with DM-2, compared to the non-diabetic patients (1,05% (n=2) and 3,68% (n=7), respectively). Therefore, PCI in STEMI patients with DM-2 substantially improved the long-term prognosis, halving the incidence of the combined end-point. By contrast, this incidence was reduced only by 1,5 among patients who did not undergo PCI. To summarise, the presence of DM-2 is associated with adverse long-term prognosis only in STEMI patients who do not undergo PCI. Conclusion. The presence of DM-2 significantly aggravates long-term prognosis in AMI patients who do not undergo PCI.

82. Prognostic value of syntax score for outcomes and revascularization strategy choice in st-segment elevation myocardial infarction patients with multivessel coronary artery disease

Author

Tarasov, R. S., Ganyukov, V. I., Shilov, A. A., Olga Barbarash, and Barbarash, L. S.

Subjects
myocardial infarction, lcsh:R, multivessel coronary artery disease, lcsh:Medicine, cardiovascular diseases, syntax score, primary percutaneous coronary intervention, humanities
Abstract

Aim. To study the prognostic significance of the SYNTAX score in the evaluation of outcomes of primary percutaneous coronary interventions (PCIs) and revascularization strategy choice in patients with ST-elevation myocardial infarction (STEMI) with multivessel coronary artery disease. Material and methods. The long-term outcomes of primary PCIs were analyzed in 163 patients with STEMI in terms of the objective assessment of the severity of the coronary bed lesion according to SYNTAX scores. Results. In a cohort of STEMI patients who had undergone primary PCI, the SYNTAX score of ≥23 (a severe lesion) was associated with the higher incidence of acute heart failure (Killip class II) and three-vessel coronary artery disease (odds ratio (OR) 2.8), with the higher risk of death (OR 7.5) and the higher rate of the combined endpoint of death, myocardial infarction, and target vessel revascularization (OR 2.8) as compared with patients with a SYNTAX score of ≤ 22 (a moderate lesion). Conclusion. The SYNTAX score has a prognostic value in assessing the outcomes of primary PCIs in the cohort of STEMI patients with multivessel disease, which can find use in the differential choice of the optimal revascularization strategy and improve treatment results. In the group of patients with a SYNTAX score of ≥ 23, the incomplete revascularization strategy shows the least favorable results as compared to multivessel stenting and staged revascularization.

83. Impact of COVID-19 pandemic and diabetes on mechanical reperfusion in patients with STEMI: insights from the ISACS STEMI COVID 19 Registry

Author

Gianluca Caiazzo, Giuseppe De Luca, Sébastien Levesque, Victor Becerra, Filippo Zilio, Gabriele Gabrielli, Xacobe Flores Rios, José Moreu, Tomas Kovarnik, Wojtek Wojakowski, Juan Sanchis Forés, Luca Donazzan, Dimitrios Alexopoulos, Gerard Rourai Ferrer, Luigi Vignali, Alessandra Scoccia, Giuseppe Uccello, Lucia Marinucci, Marco Boccalatte, Lisette Okkels Jensen, Enrico Fabris, Michał Kidawa, Miha Cercek, Ylitalo Antti, Stephane Manzo, Lucian Calmac, Gennaro Galasso, Vincenzo Guiducci, Iñigo Lozano Martínez-Luengas, Petr Kala, Elvin Kedhi, Bruno Scheller, Monica Verdoia, Bor Wilbert, Maurizio Menichelli, Benjamin Faurie, Thomas W Johnson, Alejandro Gutierrez Barrios, José Luis Díez Gil, Giuliana Cortese, Clemens von Birgelen, Guido Parodi, Raul Moreno, Francesco Versaci, Arpad Lux, Santiago Camacho-Freiere, Xavier Carrill, Periklis Davlouros, Mika Laine, Adriaan O. Kraaijeveld, Heidi Lehtola, Jurriën M. ten Berg, Gianni Casella, Vladimir Ganyukov, Ciro De Simone, Nikola Bakraceski, Rui Campante Teles, Maurits T. Dirksen, Francisco Bosa Ojeda, Marija Vavlukis, RS: Carim - H01 Clinical atrial fibrillation, Cardiologie, [De Luca,G, Verdoia,M] Division of Cardiology, Azienda Ospedaliero-Universitaria Maggiore della Carità, Università del Piemonte Orientale, Novara, Italy. giuseppe.deluca@med.uniupo.it. [Cercek,M] Centre for Intensive Internal Medicine, University Medical Centre, Ljubljana, Slovenia. [Jensen,LO] Division of Cardiology, Odense Universitets Hospital, Odense, Danemark. [Vavlukis,M] University Clinic for Cardiology, Medical Faculty, Ss' Cyril and Methodius University, Skopje, North Macedonia. [Calmac,L] Clinic Emergency Hospital of Bucharest, Bucharest, Romania. [Johnson,T] Division of Cardiology, Bristol Heart Institute, University Hospitals Bristol, NHSFT & University of Bristol, Bristol, UK. [Roura i Ferrer,G] Interventional Cardiology Unit, Heart Disease Institute, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain. [Ganyukov,V] 8Division of Cardiology, State Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russia. [Wojakowski,W] Division of Cardiology, Medical University of Silezia, Katowice, Poland. [von Birgelen,C] Department of Cardiology, Medisch Spectrum Twente, Thoraxcentrum Twente, Enschede, The Netherlands. [Versaci,F] Division of Cardiology, Ospedale Santa Maria Goretti, Latina, Italy. [Ten Berg,J] Division of Cardiology, St Antonius Hospital, Nieuwegein, The Netherlands. [Laine,L] Division of Cardiology, Helsinki University Central Hospital, Helsinki, Finland. [Dirksen,M] Division of Cardiology, Northwest Clinic, Alkmaar, The Netherlands. [Casella,G] Division of Cardiology, Ospedale Maggiore, Bologna, Italy. [Kala,P] University Hospital Brno, Medical Faculty of Masaryk University Brno, Brno, Czech Republic. [Díez Gil,JL] H. Universitario y Politécnico La Fe, Valencia, Spain. [Becerra,V] Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain. [De Simone,C] Division of Cardiology, Clinica Villa dei Fiori, Acerra, Italy. [Carrill,X] Hospital Germans Triasi Pujol, Badalona, Spain. [Scoccia,A] Division of Cardiology, Ospedale 'Sant'Anna', Ferrara, Italy. [Lux,A] Maastricht University Medical Center, Maastricht, The Netherlands. [Kovarnik,T] University Hospital Prague, Prague, Czech Republic. [Davlouros,P] Invasive Cardiology and Congenital Heart Disease, Patras University Hospital, Patras, Greece. [Gabrielli,G] Interventional Cardiology Unit, Azienda Ospedaliero Universitaria 'Ospedali Riuniti', Ancona, Italy. [Flores Rios,X] Complexo Hospitaliero Universitario La Coruna, La Coruna, Spain. [Bakraceski,N] Center for Cardiovascular Diseases, Ohrid, North Macedonia. [Levesque,S] Center Hospitalier, Universitaire de Poitiers, University Hospital, Poitiers, France. [Guiducci,V] AUSL-IRCCS Reggio Emilia, Reggio Emilia, Italy. [Kidawa,M] Central Hospital of Medical University of Lodz, Łódź, Poland. [Marinucci,L] Division of Cardiology, AziendaOspedaliera 'Ospedali Riuniti Marche Nord', Pesaro, Italy. [Zilio,F] Ospedale Santa Chiara di Trento, Trento, Italy. [Galasso,G] Division of Cardiology, Ospedale San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy. [Fabris,E] Azienda Ospedaliero - Universitaria Ospedali Riuniti Trieste, Trieste, Italy. [Menichelli,M] Division of Cardiology, Ospedale 'F. Spaziani, Frosinone, Italy. [Manzo,S] Division of Cardiology, CHU Lariboisière, AP-HP, Paris VII University, INSERM UMRS 942, Paris, France. [Caiazzo,G] Division of Cardiology, Ospedale 'G Moscati', Aversa, Italy. [Moreu,J] Division of Cardiology, Complejo Hospitalario de Toledo, Toledo, Spain. [Sanchis Forés,J] Division of Cardiology, Hospital Clinico Universitario de Valencia, Valencia, Spain. [Donazzan,L] Division of Cardiology, Ospedale 'S. Maurizio' Bolzano Ospedale 'S. Maurizio', Bolzano, Italy. [Vignali,L] Interventional Cardiology Unit, Azienda Ospedaliera Sanitaria, Parma, Italy. [Teles,R] Division of Cardiology, Hospital de Santa Cruz, CHLO - Carnaxide, Carnaxide, Portugal. [Bosa Ojeda,F] Division of Cardiology, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain. [Lehtola,H] Division of Cardiology, Oulu University Hospital, Oulu, Finland. [Camacho‑Freiere,S] Division of Cardiology, Juan Ramon Jimenez Hospital, Huelva, Spain. [Kraaijeveld,A] Division of Cardiology, UMC Utrecht, Utrecht, The Netherlands. [Antti,Y] Division of Cardiology, Heart Centre Turku, Turku, Finland. [Boccalatte,M] Division of Cardiology, Ospedale Santa Maria delle Grazie, Pozzuoli, Italy. [Lozano Martínez‑Luengas,I] Division of Cardiology, Hospital Cabueñes, Gijon, Spain. [Scheller,B] Division of Cardiology, Clinical and Experimental Interventional Cardiology, University of Saarland, Saarbrücken, Germany. [Alexopoulos,D] Division of Cardiology, Attikon University Hospital, Athens, Greece. [Faurie,B] Division of Cardiology, Ospedale 'A. Manzoni' Lecco, Lecco, Italy. [Gutierrez Barrios,A] Division of Cardiology, Groupe Hospitalier Mutualiste de Grenoble, Grenoble, France. [Wilbert,B] Division of Cardiology, Hospital Puerta del Mar, Cadiz, Spain. [Cortese,G] Department of Statistical Sciences, University of Padova, Padova, Italy. [Moreno,R] Division of Cardiology, Hospital la Paz, Madrid, Spain. [Parodi,G] Azienda Ospedaliero-Universitaria Sassari, Sassari, Italy. [Kedhi,E] Division of Cardiology, St-Jan Hospital, Brugge, Belgium. [Verdoia,M] Division of Cardiology, Ospedale degli Infermi, ASL Biella, Ponderano, Italy., HUS Heart and Lung Center, Kardiologian yksikkö, De Luca, G., Cercek, M., Jensen, L. O., Vavlukis, M., Calmac, L., Johnson, T., Roura i Ferrer, G., Ganyukov, V., Wojakowski, W., von Birgelen, C., Versaci, F., Ten Berg, J., Laine, M., Dirksen, M., Casella, G., Kala, P., Diez Gil, J. L., Becerra, V., De Simone, C., Carrill, X., Scoccia, A., Lux, A., Kovarnik, T., Davlouros, P., Gabrielli, G., Flores Rios, X., Bakraceski, N., Levesque, S., Guiducci, V., Kidawa, M., Marinucci, L., Zilio, F., Galasso, G., Fabris, E., Menichelli, M., Manzo, S., Caiazzo, G., Moreu, J., Sanchis Fores, J., Donazzan, L., Vignali, L., Teles, R., Bosa Ojeda, F., Lehtola, H., Camacho-Freiere, S., Kraaijeveld, A., Antti, Y., Boccalatte, M., Martinez-Luengas, I. L., Scheller, B., Alexopoulos, D., Uccello, G., Faurie, B., Gutierrez Barrios, A., Wilbert, B., Cortese, G., Moreno, R., Parodi, G., Kedhi, E., and Verdoia, M.

Subjects
Registrie, Male, lcsh:Diseases of the circulatory (Cardiovascular) system, Infarto del miocardio con elevación del ST, Time Factors, COVID-19/diagnosis, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Case-Control Studies::Retrospective Studies [Medical Subject Headings], Phenomena and Processes::Physical Phenomena::Time::Time Factors [Medical Subject Headings], Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, PRIMARY ANGIOPLASTY, 030204 cardiovascular system & hematology, Rate ratio, Geographical Locations::Geographic Locations::Europe::Europe, Eastern [Medical Subject Headings], Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], Time-to-Treatment/trends, 0302 clinical medicine, Retrospective Studie, Risk Factors, Síndrome coronario agudo, 030212 general & internal medicine, Myocardial infarction, Hospital Mortality, Registries, Diabetes Mellitus/diagnosis, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Patient Care::Time-to-Treatment [Medical Subject Headings], Persons::Persons::Age Groups::Adult::Aged [Medical Subject Headings], Original Investigation, Percutaneous Coronary Intervention/adverse effects, Aged, COVID-19, Diabetes Mellitus, Europe, Female, Humans, Hypertension, Middle Aged, Percutaneous Coronary Intervention, Retrospective Studies, ST Elevation Myocardial Infarction, Time-to-Treatment, Treatment Outcome, Hospital Mortality/trends, Health Care::Health Services Administration::Organization and Administration::Records as Topic::Registries [Medical Subject Headings], education.field_of_study, Incidence (epidemiology), Analytical, Diagnostic and Therapeutic Techniques and Equipment::Surgical Procedures, Operative::Cardiovascular Surgical Procedures::Vascular Surgical Procedures::Endovascular Procedures::Percutaneous Coronary Intervention [Medical Subject Headings], Diabetes Mellitu, Intervención coronaria percutánea, 3. Good health, surgical procedures, operative, Acute coronary syndrome, Cardiology and Cardiovascular Medicine, Human, medicine.medical_specialty, ACUTE MYOCARDIAL-INFARCTION, Time Factor, Population, Health Care::Environment and Public Health::Public Health::Epidemiologic Factors::Causality::Risk Factors [Medical Subject Headings], Europe/epidemiology, Diseases::Cardiovascular Diseases::Vascular Diseases::Hypertension [Medical Subject Headings], 03 medical and health sciences, Hypertension/epidemiology, Internal medicine, Diabetes mellitus, medicine, cardiovascular diseases, education, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Prognosis::Treatment Outcome [Medical Subject Headings], Pandemia, Pandemic, Diseases::Endocrine System Diseases::Diabetes Mellitus [Medical Subject Headings], ST Elevation Myocardial Infarction/mortality, business.industry, Risk Factor, MORTALITY, Percutaneous coronary intervention, Persons::Persons::Age Groups::Adult::Middle Aged [Medical Subject Headings], Retrospective cohort study, medicine.disease, Diseases::Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections [Medical Subject Headings], lcsh:RC666-701, 3121 General medicine, internal medicine and other clinical medicine, Reperfusion, Conventional PCI, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Vital Statistics::Mortality::Hospital Mortality [Medical Subject Headings], business
Abstract

Background It has been suggested the COVID pandemic may have indirectly affected the treatment and outcome of STEMI patients, by avoidance or significant delays in contacting the emergency system. No data have been reported on the impact of diabetes on treatment and outcome of STEMI patients, that was therefore the aim of the current subanalysis conducted in patients included in the International Study on Acute Coronary Syndromes–ST Elevation Myocardial Infarction (ISACS-STEMI) COVID-19. Methods The ISACS-STEMI COVID-19 is a retrospective registry performed in European centers with an annual volume of > 120 primary percutaneous coronary intervention (PCI) and assessed STEMI patients, treated with primary PCI during the same periods of the years 2019 versus 2020 (March and April). Main outcomes are the incidences of primary PCI, delayed treatment, and in-hospital mortality. Results A total of 6609 patients underwent primary PCI in 77 centers, located in 18 countries. Diabetes was observed in a total of 1356 patients (20.5%), with similar proportion between 2019 and 2020. During the pandemic, there was a significant reduction in primary PCI as compared to 2019, similar in both patients with (Incidence rate ratio (IRR) 0.79 (95% CI: 0.73–0.85, p p p Furthermore, the pandemic was independently associated with a significant increase in door-to-balloon and total ischemia times only among patients without diabetes, which may have contributed to the higher mortality, during the pandemic, observed in this group of patients. Conclusions The COVID-19 pandemic had a significant impact on the treatment of patients with STEMI, with a similar reduction in primary PCI procedures in both patients with and without diabetes. Hypertension had a significant impact on PCI reduction only among patients without diabetes. We observed a significant increase in ischemia time and door-to-balloon time mainly in absence of diabetes, that contributed to explain the increased mortality observed in this group of patients during the pandemic. Trial registration number: NCT 04412655.

Published
2020

84. Gender Difference in the Effects of COVID-19 Pandemic on Mechanical Reperfusion and 30-Day Mortality for STEMI: Results of the ISACS-STEMI COVID-19 Registry

Author

Giuseppe De Luca, Stephane Manzo-Silberman, Magdy Algowhary, Berat Uguz, Dinaldo C. Oliveira, Vladimir Ganyukov, Oliver Busljetik, Miha Cercek, Lisette Okkels, Poay Huan Loh, Lucian Calmac, Gerard Roura i Ferrer, Alexandre Quadros, Marek Milewski, Fortunato Scotto di Uccio, Clemens von Birgelen, Francesco Versaci, Jurrien Ten Berg, Gianni Casella, Aaron Wong Sung Lung, Petr Kala, José Luis Díez Gil, Xavier Carrillo, Maurits Dirksen, Victor Becerra, Michael Kang-yin Lee, Dafsah Arifa Juzar, Rodrigo de Moura Joaquim, Roberto Paladino, Davor Milicic, Periklis Davlouros, Nikola Bakraceski, Filippo Zilio, Luca Donazzan, Adriaan Kraaijeveld, Gennaro Galasso, Lux Arpad, Lucia Marinucci, Vincenzo Guiducci, Maurizio Menichelli, Alessandra Scoccia, Aylin Hatice Yamac, Kadir Ugur Mert, Xacobe Flores Rios, Tomas Kovarnik, Michal Kidawa, Josè Moreu, Vincent Flavien, Enrico Fabris, Iñigo Lozano Martínez-Luengas, Marco Boccalatte, Francisco Bosa Ojeda, Carlos Arellano-Serrano, Gianluca Caiazzo, Giuseppe Cirrincione, Hsien-Li Kao, Juan Sanchis Forés, Luigi Vignali, Helder Pereira, Santiago Ordoñez, Alev Arat Özkan, Bruno Scheller, Heidi Lehtola, Rui Teles, Christos Mantis, Ylitalo Antti, João António Brum Silveira, Cesar Rodrigo Zoni, Ivan Bessonov, Giuseppe Uccello, George Kochiadakis, Dimitrios Alexopulos, Carlos E. Uribe, John Kanakakis, Benjamin Faurie, Gabriele Gabrielli, Alejandro Gutierrez Barrios, Juan Pablo Bachini, Alex Rocha, Frankie C. C. Tam, Alfredo Rodriguez, Antonia Anna Lukito, Veauthyelau Saint-Joy, Gustavo Pessah, Andrea Tuccillo, Alfonso Ielasi, Giuliana Cortese, Guido Parodi, Mohamed Abed Bouraghda, Marcia Moura, Elvin Kedhi, Pablo Lamelas, Harry Suryapranata, Matteo Nardin, Monica Verdoia, MUMC+: MA Med Staf Spec Cardiologie (9), RS: Carim - H01 Clinical atrial fibrillation, Cardiologie, De Luca, G., Manzo-Silberman, S., Algowhary, M., Uguz, B., Oliveira, D. C., Ganyukov, V., Busljetik, O., Cercek, M., Okkels, L., Loh, P. H., Calmac, L., Ferrer, G. R. I., Quadros, A., Milewski, M., Scotto di Uccio, F., von Birgelen, C., Versaci, F., Ten Berg, J., Casella, G., Wong Sung Lung, A., Kala, P., Diez Gil, J. L., Carrillo, X., Dirksen, M., Becerra, V., Lee, M. K. -Y., Juzar, D. A., de Moura Joaquim, R., Paladino, R., Milicic, D., Davlouros, P., Bakraceski, N., Zilio, F., Donazzan, L., Kraaijeveld, A., Galasso, G., Arpad, L., Marinucci, L., Guiducci, V., Menichelli, M., Scoccia, A., Yamac, A. H., Ugur Mert, K., Flores Rios, X., Kovarnik, T., Kidawa, M., Moreu, J., Flavien, V., Fabris, E., Martinez-Luengas, I. L., Boccalatte, M., Ojeda, F. B., Arellano-Serrano, C., Caiazzo, G., Cirrincione, G., Kao, H. -L., Fores, J. S., Vignali, L., Pereira, H., Ordonez, S., Arat Ozkan, A., Scheller, B., Lehtola, H., Teles, R., Mantis, C., Antti, Y., Brum Silveira, J. A., Zoni, C. R., Bessonov, I., Uccello, G., Kochiadakis, G., Alexopulos, D., Uribe, C. E., Kanakakis, J., Faurie, B., Gabrielli, G., Barrios, A. G., Bachini, J. P., Rocha, A., Tam, F. C. C., Rodriguez, A., Lukito, A. A., Saint-Joy, V., Pessah, G., Tuccillo, A., Ielasi, A., Cortese, G., Parodi, G., Bouraghda, M. A., Moura, M., Kedhi, E., Lamelas, P., Suryapranata, H., Nardin, M., and Verdoia, M.

Subjects
IMPACT, Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], percutaneous coronary intervention, PRIMARY ANGIOPLASTY, COVID-19, General Medicine, ADMISSION, ST-segment elevation myocardial infarction, INSIGHTS, WUHAN, All institutes and research themes of the Radboud University Medical Center, CLINICAL CHARACTERISTICS, ELEVATION-MYOCARDIAL-INFARCTION, gender, MANAGEMENT, Factors sexuals en les malalties, Sex factors in disease
Abstract

Contains fulltext : 290798.pdf (Publisher’s version ) (Open Access) BACKGROUND: Several reports have demonstrated the impact of the COVID-19 pandemic on the management and outcome of patients with ST-segment elevation myocardial infarction (STEMI). The aim of the current analysis is to investigate the potential gender difference in the effects of the COVID-19 pandemic on mechanical reperfusion and 30-day mortality for STEMI patients within the ISACS-STEMI COVID-19 Registry. METHODS: This retrospective multicenter registry was performed in high-volume primary percutaneous coronary intervention (PPCI) centers on four continents and included STEMI patients undergoing PPCIs in March-June 2019 and 2020. Patients were divided according to gender. The main outcomes were the incidence and timing of the PPCI, (ischemia time ≥ 12 h and door-to-balloon ≥ 30 min) and in-hospital or 30-day mortality. RESULTS: We included 16683 STEMI patients undergoing PPCIs in 109 centers. In 2020 during the pandemic, there was a significant reduction in PPCIs compared to 2019 (IRR 0.843 (95% CI: 0.825-0.861, p < 0.0001). We did not find a significant gender difference in the effects of the COVID-19 pandemic on the numbers of STEMI patients, which were similarly reduced from 2019 to 2020 in both groups, or in the mortality rates. Compared to prepandemia, 30-day mortality was significantly higher during the pandemic period among female (12.1% vs. 8.7%; adjusted HR [95% CI] = 1.66 [1.31-2.11], p < 0.001) but not male patients (5.8% vs. 6.7%; adjusted HR [95% CI] = 1.14 [0.96-1.34], p = 0.12). CONCLUSIONS: The COVID-19 pandemic had a significant impact on the treatment of patients with STEMI, with a 16% reduction in PPCI procedures similarly observed in both genders. Furthermore, we observed significantly increased in-hospital and 30-day mortality rates during the pandemic only among females. Trial registration number: NCT 04412655.

Published
2023

85. Impact of chronic obstructive pulmonary disease on short-term outcome in patients with ST-elevation myocardial infarction during COVID-19 pandemic

Author

Giuseppe De Luca, Matteo Nardin, Magdy Algowhary, Berat Uguz, Dinaldo C. Oliveira, Vladimir Ganyukov, Zan Zimbakov, Miha Cercek, Lisette Okkels Jensen, Poay Huan Loh, Lucian Calmac, Gerard Roura Ferrer, Alexandre Quadros, Marek Milewski, Fortunato Scotto di Uccio, Clemens von Birgelen, Francesco Versaci, Jurrien Ten Berg, Gianni Casella, Aaron Wong Sung Lung, Petr Kala, José Luis Díez Gil, Xavier Carrillo, Maurits Dirksen, Victor M. Becerra-Munoz, Michael Kang-yin Lee, Dafsah Arifa Juzar, Rodrigo de Moura Joaquim, Roberto Paladino, Davor Milicic, Periklis Davlouros, Nikola Bakraceski, Filippo Zilio, Luca Donazzan, Adriaan Kraaijeveld, Gennaro Galasso, Arpad Lux, Lucia Marinucci, Vincenzo Guiducci, Maurizio Menichelli, Alessandra Scoccia, Aylin Hatice Yamac, Kadir Ugur Mert, Xacobe Flores Rios, Tomas Kovarnik, Michal Kidawa, Josè Moreu, Vincent Flavien, Enrico Fabris, Iñigo Lozano Martínez-Luengas, Marco Boccalatte, Francisco Bosa Ojeda, Carlos Arellano-Serrano, Gianluca Caiazzo, Giuseppe Cirrincione, Hsien-Li Kao, Juan Sanchis Forés, Luigi Vignali, Helder Pereira, Stephane Manzo, Santiago Ordoñez, Alev Arat Özkan, Bruno Scheller, Heidi Lehtola, Rui Teles, Christos Mantis, Ylitalo Antti, João A. Brum Silveira, Rodrigo Zoni, Ivan Bessonov, Stefano Savonitto, George Kochiadakis, Dimitrios Alexopoulos, Carlos E. Uribe, John Kanakakis, Benjamin Faurie, Gabriele Gabrielli, Alejandro Gutierrez Barrios, Juan Pablo Bachini, Alex Rocha, Frankie Chor-Cheung Tam, Alfredo Rodriguez, Antonia Anna Lukito, Veauthyelau Saint-Joy, Gustavo Pessah, Andrea Tuccillo, Giuliana Cortese, Guido Parodi, Mohamed Abed Bouraghda, Elvin Kedhi, Pablo Lamelas, Harry Suryapranata, Monica Verdoia, De Luca, G., Nardin, M., Algowhary, M., Uguz, B., Oliveira, D. C., Ganyukov, V., Zimbakov, Z., Cercek, M., Okkels Jensen, L., Loh, P. H., Calmac, L., Roura Ferrer, G., Quadros, A., Milewski, M., Scotto di Uccio, F., von Birgelen, C., Versaci, F., Ten Berg, J., Casella, G., Wong Sung Lung, A., Kala, P., Diez Gil, J. L., Carrillo, X., Dirksen, M., Becerra-Munoz, V. M., Lee, M. K. -Y., Arifa Juzar, D., de Moura Joaquim, R., Paladino, R., Milicic, D., Davlouros, P., Bakraceski, N., Zilio, F., Donazzan, L., Kraaijeveld, A., Galasso, G., Lux, A., Marinucci, L., Guiducci, V., Menichelli, M., Scoccia, A., Yamac, A. H., Ugur Mert, K., Flores Rios, X., Kovarnik, T., Kidawa, M., Moreu, J., Flavien, V., Fabris, E., Martinez-Luengas, I. L., Boccalatte, M., Bosa Ojeda, F., Arellano-Serrano, C., Caiazzo, G., Cirrincione, G., Kao, H. -L., Sanchis Fores, J., Vignali, L., Pereira, H., Manzo, S., Ordonez, S., Ozkan, A. A., Scheller, B., Lehtola, H., Teles, R., Mantis, C., Antti, Y., Brum Silveira, J. A., Zoni, R., Bessonov, I., Savonitto, S., Kochiadakis, G., Alexopoulos, D., Uribe, C. E., Kanakakis, J., Faurie, B., Gabrielli, G., Gutierrez Barrios, A., Bachini, J. P., Rocha, A., Tam, F. C. -C., Rodriguez, A., Lukito, A. A., Saint-Joy, V., Pessah, G., Tuccillo, A., Cortese, G., Parodi, G., Bouraghda, M. A., Kedhi, E., Lamelas, P., Suryapranata, H., Verdoia, M., MUMC+: MA Med Staf Spec Cardiologie (9), RS: Carim - H01 Clinical atrial fibrillation, and Cardiologie

Subjects
Chronic Obstructive, ST Elevation Myocardial Infarction/diagnosis, TROPONIN ELEVATION, PRIMARY ANGIOPLASTY, COVID-19 Pandemic, 2020, Pulmonary Disease, STEMI, Pulmonary Disease, Chronic Obstructive, Percutaneous Coronary Intervention, Chronic Obstructive/diagnosis, MANAGEMENT, Pandèmia de COVID-19, 2020, Humans, COPD, Hospital Mortality, Registries, Chronic obstructive pulmonary diseases, Mortality, Pandemics, Malalties pulmonars obstructives cròniques, Aged, COVID-19/epidemiology, Percutaneous Coronary Intervention/adverse effects, Retrospective Studies, SARS-CoV-2, MORTALITY, SEGMENT ELEVATION, Treatment Outcome, COVID-19, ST Elevation Myocardial Infarction, Infart de miocardi, Myocardial infarction, ACUTE EXACERBATION, Pulmonary Disease, Chronic Obstructive/diagnosis
Abstract

Background Chronic obstructive pulmonary disease (COPD) is projected to become the third cause of mortality worldwide. COPD shares several pathophysiological mechanisms with cardiovascular disease, especially atherosclerosis. However, no definite answers are available on the prognostic role of COPD in the setting of ST elevation myocardial infarction (STEMI), especially during COVID-19 pandemic, among patients undergoing primary angioplasty, that is therefore the aim of the current study. Methods In the ISACS-STEMI COVID-19 registry we included retrospectively patients with STEMI treated with primary percutaneous coronary intervention (PCI) between March and June of 2019 and 2020 from 109 high-volume primary PCI centers in 4 continents. Results A total of 15,686 patients were included in this analysis. Of them, 810 (5.2%) subjects had a COPD diagnosis. They were more often elderly and with a more pronounced cardiovascular risk profile. No preminent procedural dissimilarities were noticed except for a lower proportion of dual antiplatelet therapy at discharge among COPD patients (98.9% vs. 98.1%, P = 0.038). With regards to short-term fatal outcomes, both in-hospital and 30-days mortality occurred more frequently among COPD patients, similarly in pre-COVID-19 and COVID-19 era. However, after adjustment for main baseline differences, COPD did not result as independent predictor for in-hospital death (adjusted OR [95% CI] = 0.913[0.658–1.266], P = 0.585) nor for 30-days mortality (adjusted OR [95% CI] = 0.850 [0.620–1.164], P = 0.310). No significant differences were detected in terms of SARS-CoV-2 positivity between the two groups. Conclusion This is one of the largest studies investigating characteristics and outcome of COPD patients with STEMI undergoing primary angioplasty, especially during COVID pandemic. COPD was associated with significantly higher rates of in-hospital and 30-days mortality. However, this association disappeared after adjustment for baseline characteristics. Furthermore, COPD did not significantly affect SARS-CoV-2 positivity. Trial registration number: NCT 04412655 (2nd June 2020).

Published
2022

86. Impact of COVID-19 Pandemic on Mechanical Reperfusion for Patients With STEMI

Author

Giuseppe De Luca, Pierre Deharo, Pierfrancesco Agostoni, Gabriele Gabrielli, Francisco Bosa Ojeda, Ylitalo Antti, Lisette Okkels Jensen, Bor Wilbert, Luigi Vignali, Fortunato Scotto Di Uccio, Dariusz Dudek, Marco Boccalatte, Monica Verdoia, Edouard Benit, Gianni Casella, Heidi Lehtola, Alessandra Scoccia, Tim Kinnaird, Massimo Siviglia, Raul Moreno, Vladimir Ganyukov, Arpad Lux, Mika Laine, Adrian P. Banning, Santiago Camacho-Freiere, Guido Parodi, José Moreu, Michał Kidawa, Miha Cercek, Victor Becerra, Stephane Manzo, Elvin Kedhi, Marija Vavlukis, Filippo Zilio, Ciro De Simone, Nikola Bakraceski, Xavier Carrillo, Giuseppe Uccello, Maurizio Menichelli, Gerard Rourai Ferrer, Dimitrios Alexopoulos, Benjamin Faurie, Jurriën M. ten Berg, Lucia Marinucci, Juan Sanchis Forés, Giovanni Amoroso, Sébastien Levesque, Bernardo Tuccillo, Enrico Fabris, Peter Ludman, Rui Campante Teles, Wojtek Wojakowski, Leonardo Spedicato, Lucian Calmac, Yves Cottin, Maurits T. Dirksen, Petr Kala, Thomas W Johnson, Xacobe Flores Rios, Gianluca Caiazzo, Clemens van Birgelen, Francesco Versaci, Alexander Ijsselmuiden, Luca Donazzan, Kees-Jan Royaards, Adriaan O. Kraaijeveld, Alejandro Gutierrez Barrios, Gennaro Galasso, Vincenzo Guiducci, Julinda Mehilli, Giuseppe Cirrincione, Andrea Santucci, Giuliana Cortese, José Luis Díez Gil, Iñigo Lozano Martínez-Luengas, Bruno Scheller, Periklis Davlouros, Tomas Kovarnik, Arturo García-Touchard, Pieter C. Smits, De Luca, G., Verdoia, M., Cercek, M., Jensen, L. O., Vavlukis, M., Calmac, L., Johnson, T., Ferrer, G. R., Ganyukov, V., Wojakowski, W., Kinnaird, T., van Birgelen, C., Cottin, Y., Ijsselmuiden, A., Tuccillo, B., Versaci, F., Royaards, K. -J., Berg, J. T., Laine, M., Dirksen, M., Siviglia, M., Casella, G., Kala, P., Diez Gil, J. L., Banning, A., Becerra, V., De Simone, C., Santucci, A., Carrillo, X., Scoccia, A., Amoroso, G., Lux, A., Kovarnik, T., Davlouros, P., Mehilli, J., Gabrielli, G., Rios, X. F., Bakraceski, N., Levesque, S., Cirrincione, G., Guiducci, V., Kidawa, M., Spedicato, L., Marinucci, L., Ludman, P., Zilio, F., Galasso, G., Fabris, E., Menichelli, M., Garcia-Touchard, A., Manzo, S., Caiazzo, G., Moreu, J., Fores, J. S., Donazzan, L., Vignali, L., Teles, R., Benit, E., Agostoni, P., Bosa Ojeda, F., Lehtola, H., Camacho-Freiere, S., Kraaijeveld, A., Antti, Y., Boccalatte, M., Deharo, P., Martinez-Luengas, I. L., Scheller, B., Alexopulos, D., Moreno, R., Kedhi, E., Uccello, G., Faurie, B., Gutierrez Barrios, A., Di Uccio, F. S., Wilbert, B., Smits, P., Cortese, G., Parodi, G., Dudek, D., banning, adrian/0000-0002-2842-7861, GUIDUCCI, VINCENZO/0000-0002-0833-2785, vavlukis, marija/0000-0002-4479-6691, Bor, Willem L/0000-0002-3253-5961, DAVLOUROS, PERIKLIS/0000-0002-1439-1992, Uccello, Giuseppe/0000-0002-6163-8468, Kidawa, Michal/0000-0002-5000-6561, [De Luca, Giuseppe] Univ Piemonte Orientale, Div Cardiol, Azienda Osped Univ Maggiore Carita, Novara, Italy, [Verdoia, Monica] Osped Inferm Biella, ASL Biella, Div Cardiol, Biella, Italy, [Cercek, Miha] Univ Med Ctr, Ctr Intens Internal Med, Ljubljana, Slovenia, [Jensen, Lisette Okkels] Odense Univ Hosp, Div Cardiol, Odense, Denmark, [Vavlukis, Marija] Ss Cyril & Methodius Univ, Med Fac, Univ Clin Cardiol, Skopje, North Macedonia, [Calmac, Lucian] Clin Emergency Hosp Bucharest, Bucharest, Romania, [Johnson, Tom] Univ Hosp Bristol NHSFT, Bristol Heart Inst, Div Cardiol, Bristol, Avon, England, [Johnson, Tom] Univ Bristol, Bristol, Avon, England, [Ferrer, Gerard Rourai] Hosp Univ Bellvitge, Heart Dis Inst, Intervent Cardiol Unit, Barcelona, Spain, [Ganyukov, Vladimir] State Res Inst Complex Issues Cardiovasc Dis, Div Cardiol, Kemerovo, Russia, [Wojakowski, Wojtek] Med Univ Silezia, Div Cardiol, Katowice, Poland, [Kinnaird, Tim] Univ Hosp Wales, Div Cardiol, Cardiff, Wales, [van Birgelen, Clemens] Thoraxctr Twente, Dept Cardiol, Med Spectrum Twente, Enschede, Netherlands, [Cottin, Yves] Univ Hosp, Div Cardiol, Dijon, France, [IJsselmuiden, Alexander] Amphia Hosp, Div Cardiol, Breda, Netherlands, [Tuccillo, Bernardo] Osped Mare, Div Cardiol, Naples, Italy, [Di Uccio, Fortunato Scotto] Osped Mare, Div Cardiol, Naples, Italy, [Versaci, Francesco] Osped Santa Maria Goretti, Div Cardiol, Latina, Italy, [Royaards, Kees-Jan] Maasstad Ziekenhuis, Div Cardiol, Rotterdam, Netherlands, [Smits, Pieter] Maasstad Ziekenhuis, Div Cardiol, Rotterdam, Netherlands, [Ten Berg, Jurrien] St Antonius Hosp, Div Cardiol, Nieuwegein, Netherlands, [Wilbert, Bor] St Antonius Hosp, Div Cardiol, Nieuwegein, Netherlands, [Laine, Mika] Helsinki Univ Cent Hosp, Div Cardiol, Helsinki, Finland, [Dirksen, Maurits] Northwest Clin, Div Cardiol, Alkmaar, Netherlands, [Siviglia, Massimo] Osped Riuniti Reggio Calabria, Div Cardiol, Reggio Di Calabria, Italy, [Casella, Gianni] Osped Maggiore Bologna, Div Cardiol, Bologna, Italy, [Kala, Petr] Masaryk Univ, Univ Hosp Brno, Med Fac, Brno, Czech Republic, [Diez Gil, Jose Luis] H Univ & Politecn La Fe, Valencia, Spain, [Banning, Adrian] John Radcliffe Hosp, Oxford, England, [Becerra, Victor] Hosp Clin Univ Virgen Victoria, Malaga, Spain, [De Simone, Ciro] Clin Villa Fiori, Div Cardiol, Acerra, Italy, [Santucci, Andrea] Osped Santa Maria Misericordia, Perugia, Italy, [Carrillo, Xavier] Hosp Germans Triasi Pujol, Badalona, Spain, [Scoccia, Alessandra] Osped St Anna, Div Cardiol, Ferrara, Italy, [Amoroso, Giovanni] Onze Lieve Vrouwe Gasthuis OLVG, Amsterdam, Netherlands, [Lux, Arpad] Mastricht Univ, Med Ctr, Maastricht, Netherlands, [Kovarnik, Tomas] Charles Univ Hosp, Prague, Czech Republic, [Davlouros, Periklis] Patras Univ Hosp, Invas Cardiol & Congenital Heart Dis, Patras, Greece, [Mehilli, Julinda] Ludwig Maximilians Univ Munchen, Univ Hosp Munich, Munich, Germany, [Gabrielli, Gabriele] Azienda Osped Univ, Intervent Cardiol Unit, Osped Riuniti, Ancona, Italy, [Rios, Xacobe Flores] Complexo Hosp Univ La Coruna, La Coruna, Spain, [Bakraceski, Nikola] Ctr Cardiovasc Dis, Ohrid, North Macedonia, [Levesque, Sebastien] CHU Poitiers, Univ Hosp, Poitiers, France, [Cirrincione, Giuseppe] Osped Civ Arnas, Div Cardiol, Palermo, Italy, [Guiducci, Vincenzo] AUSL IRCCS, Reggio Emilia, Italy, [Kidawa, Michal] Med Univ Lodz, Cent Hosp, Lodz, Poland, [Spedicato, Leonardo] Osped Santa Maria Misericordia, Div Cardiol, Udine, Italy, [Marinucci, Lucia] Osped Riuniti Marche Nord, Div Cardiol, Azienda Osped, Pesaro, Italy, [Ludman, Peter] Univ Hosp Birmingham, Birmingham, W Midlands, England, [Zilio, Filippo] Osped Santa Chiara, Trento, Italy, [Galasso, Gennaro] Osped San Giovanni Dio Ruggi Aragona, Div Cardiol, Salerno, Italy, [Fabris, Enrico] Univ Ospedali Riuniti, Azienda Osped, Trieste, Italy, [Menichelli, Maurizio] Osped F Spaziani, Div Cardiol, Frosinone, Italy, [Garcia-Touchard, Arturo] Hosp Puerta Hierro, Div Cardiol, Majadahonda, Spain, [Manzo, Stephane] Paris 07 Univ, CHU Lariboisiere, AP HP, Div Cardiol,INSERM,UMRS 942, Paris, France, [Caiazzo, Gianluca] Osped G Moscati, Div Cardiol, Aversa, Italy, [Moreu, Jose] Complejo Hosp Toledo, Div Cardiol, Toledo, Spain, [Sanchis Fores, Juan] Hosp Clin Univ Valencia, Div Cardiol, Valencia, Spain, [Donazzan, Luca] Osped S Maurizio Bolzano, Div Cardiol, Bolzano, Italy, [Vignali, Luigi] Azienda Osped Sanitaria, Intervent Cardiol Unit, Parma, Italy, [Teles, Rui] Hosp Santa Cruz, Div Cardiol, CHLO Carnaxide, Lisbon, Portugal, [Benit, Edouard] Jessa Ziekenhuis, Div Cardiol, Hasselt, Belgium, [Agostoni, Pierfrancesco] Ziekenhuis Netwerk Antwerpen ZNA Middelheim, Div Cardiol, Antwerp, Belgium, [Bosa Ojeda, Francisco] Hosp Univ Canarias, Div Cardiol, Santa Cruz De Tenerife, Spain, [Lehtola, Heidi] Oulu Univ Hosp, Div Cardiol, Oulu, Finland, [Camacho-Freiere, Santiago] Juan Ramon Jimenez Hosp, Div Cardiol, Huelva, Spain, [Kraaijeveld, Adriaan] UMC Utrecht, Div Cardiol, Utrecht, Netherlands, [Antti, Ylitalo] Univ Hosp, Heart Ctr, Div Cardiol, Turku, Finland, [Boccalatte, Marco] Osped Santa Maria Grazie, Div Cardiol, Pozzuoli, Italy, [Deharo, Pierre] Aix Marseille Univ, CHU Timone, Div Cardiol, Marseille, France, [Lozano Martinez-Luengas, Inigo] Hosp Cabuenes, Div Cardiol, Gijon, Spain, [Scheller, Bruno] Univ Saarland, Div Cardiol Clin & Expt Intervent Cardiol, Homburg, Germany, [Alexopoulos, Dimitrios] Attikon Univ Hosp, Div Cardiol, Athens, Greece, [Moreno, Raul] Hosp Paz, Div Cardiol, Madrid, Spain, [Kedhi, Elvin] St Jan Hosp, Div Cardiol, Brugge, Belgium, [Uccello, Giuseppe] Osped A Manzoni Lecco, Div Cardiol, Lecce, Italy, [Faurie, Benjamin] Grp Hosp Mutualiste Grenoble, Div Cardiol, Grenoble, France, [Gutierrez Barrios, Alejandro] Hosp Puerta Mar, Div Cardiol, Cadiz, Spain, [Cortese, Giuliana] Univ Padua, Dept Stat Sci, Padua, Italy, [Parodi, Guido] Azienda Osped Univ Sassari, Sassari, Italy, [Dudek, Dariusz] Jagiellonian Univ Med Coll, Inst Cardiol, Krakow, Poland, RS: Carim - H01 Clinical atrial fibrillation, and Cardiologie

Subjects
Male, Internationality, medical decision-making, medicine.medical_treatment, 030204 cardiovascular system & hematology, Rate ratio, COVID-19 (coronavirus), Settore MED/06, 0302 clinical medicine, Pandemic, Percutaneous Coronary Intervention/statistics & numerical data, Medicine, Viral, 030212 general & internal medicine, Myocardial infarction, Registries, Acute myocardial-infarction, Original Investigation, STEMI, ST-segment elevation myocardial infarction, Middle Aged, 3. Good health, Europe, fibrinolysis, Female, COVID-19, primary angioplasty, STEMI, Aged, Humans, Percutaneous Coronary Intervention, Retrospective Studies, ST Elevation Myocardial Infarction, Coronavirus Infections, Pandemics, Pneumonia, Viral, Cardiology and Cardiovascular Medicine, Editorial Comment, ACUTE MYOCARDIAL-INFARCTION, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Primary angioplasty, IRR, incidence rate ratio, Europe/epidemiology, 03 medical and health sciences, Betacoronavirus, cardiovascular diseases, Mortality, PCI, percutaneous coronary intervention, DES, drug-eluting stent(s), business.industry, ST Elevation Myocardial Infarction/mortality, PPCI, primary PCI, SARS-CoV-2, MORTALITY, Percutaneous coronary intervention, Retrospective cohort study, Pneumonia, medicine.disease, Confidence interval, ST-segment elevation myocardial infarction, CI, confidence interval, Emergency medicine, COVID-19, STEMI, primary angioplasty, ACS, acute coronary syndrome, business
Abstract

Background The fear of contagion during the coronavirus disease-2019 (COVID-19) pandemic may have potentially refrained patients with ST-segment elevation myocardial infarction (STEMI) from accessing the emergency system, with subsequent impact on mortality. Objectives The ISACS-STEMI COVID-19 registry aims to estimate the true impact of the COVID-19 pandemic on the treatment and outcome of patients with STEMI treated by primary percutaneous coronary intervention (PPCI), with identification of “at-risk” patient cohorts for failure to present or delays to treatment. Methods This retrospective registry was performed in European high-volume PPCI centers and assessed patients with STEMI treated with PPPCI in March/April 2019 and 2020. Main outcomes are the incidences of PPCI, delayed treatment, and in-hospital mortality. Results A total of 6,609 patients underwent PPCI in 77 centers, located in 18 countries. In 2020, during the pandemic, there was a significant reduction in PPCI as compared with 2019 (incidence rate ratio: 0.811; 95% confidence interval: 0.78 to 0.84; p, Central Illustration

Published
2020

87. Impact of SARS-CoV-2 positivity on clinical outcome among STEMI patients undergoing mechanical reperfusion: Insights from the ISACS STEMI COVID 19 registry

Author

Pierre Deharo, Pieter C. Smits, Giuseppe De Luca, Luigi Vignali, Clemens von Birgelen, Michał Kidawa, Lucia Marinucci, Gabriele Gabrielli, Miha Cercek, Francisco Bosa Ojeda, Bernardo Tuccillo, Lisette Okkels Jensen, Gennaro Galasso, Vincenzo Guiducci, Pierfrancesco Agostoni, Monica Verdoia, Edouard Benit, Ewout Bruwiere, Massimo Siviglia, Maurizio Menichelli, Heidi Lehtola, Stephane Manzo, Benjamin Faurie, Filippo Zilio, Gerard Rourai Ferrer, José Moreu, Guido Parodi, Ylitalo Antti, Rui Campante Teles, Giovanni Amoroso, Jurriën M. ten Berg, Sébastien Levesque, Bor Wilbert, Fortunato Scotto Di Uccio, Maurits T. Dirksen, Raul Moreno, Kees Jan Royaards, Xavier Carrillo, Giuseppe Uccello, Alejandro Gutierrez Barrios, Lucian Calmac, Victor Becerra, Petr Kala, Thomas W Johnson, Wojtek Wojakowski, Marija Vavlukis, Leonardo Spedicato, Adriaan O. Kraaijeveld, Francesco Versaci, Marco Boccalatte, Xacobe Flores Rios, Alessandra Scoccia, Arnoud W J van 't Hof, Efthymia Varytimiadi, Peter Ludman, José Luis Díez Gil, Tomas Kovarnik, Gianni Casella, Tim Kinnaird, Adrian P. Banning, Vladimir Ganyukov, Arturo García-Touchard, Marek Milewski, Ciro De Simone, Nikola Bakraceski, Julinda Mehilli, Giuseppe Cirrincione, Grigorios Tsigkas, Juan Sanchis Forés, Andrea Santucci, Elvin Kedhi, Gianluca Caiazzo, Luca Donazzan, Alexander Ijsselmuiden, Iñigo Lozano Martínez-Luengas, Bruno Scheller, Enrico Fabris, Mika Laine, Yves Cottin, Niels Debel, Santiago Camacho-Freiere, Health Technology & Services Research, RS: Carim - H01 Clinical atrial fibrillation, Cardiologie, MUMC+: MA Med Staf Spec Cardiologie (9), HUS Heart and Lung Center, Kardiologian yksikkö, De Luca, G., Debel, N., Cercek, M., Jensen, L. O., Vavlukis, M., Calmac, L., Johnson, T., Ferrer, G. R., Ganyukov, V., Wojakowski, W., Kinnaird, T., von Birgelen, C., Cottin, Y., Ijsselmuiden, A., Tuccillo, B., Versaci, F., Royaards, K. -J., Berg, J. T., Laine, M., Dirksen, M., Siviglia, M., Casella, G., Kala, P., Diez Gil, J. L., Banning, A., Becerra, V., De Simone, C., Santucci, A., Carrillo, X., Scoccia, A., Amoroso, G., van't Hof, A. W., Kovarnik, T., Tsigkas, G., Mehilli, J., Gabrielli, G., Rios, X. F., Bakraceski, N., Levesque, S., Cirrincione, G., Guiducci, V., Kidawa, M., Spedicato, L., Marinucci, L., Ludman, P., Zilio, F., Galasso, G., Fabris, E., Menichelli, M., Garcia-Touchard, A., Manzo, S., Caiazzo, G., Moreu, J., Fores, J. S., Donazzan, L., Vignali, L., Teles, R., Benit, E., Agostoni, P., Ojeda, F. B., Lehtola, H., Camacho-Freiere, S., Kraaijeveld, A., Antti, Y., Boccalatte, M., Deharo, P., Martinez-Luengas, I. L., Scheller, B., Varytimiadi, E., Moreno, R., Uccello, G., Faurie, B., Gutierrez Barrios, A., Milewski, M., Bruwiere, E., Smits, P., Wilbert, B., Di Uccio, F. S., Parodi, G., Kedhi, E., Verdoia, M., vavlukis, marija/0000-0002-4479-6691, banning, adrian/0000-0002-2842-7861, Agostoni, Pierfrancesco/0000-0002-1505-9369, Jensen, Lisette Okkels/0000-0002-4838-2429, Cercek, Miha/0000-0001-6193-0349, Milewski, Marek/0000-0001-5459-9125, Johnson, Thomas/0000-0003-4638-601X, and Calmac, Lucian/0000-0002-3031-8023

Subjects
Registrie, ST Elevation Myocardial Infarction/diagnosis, medicine.medical_treatment, PRIMARY ANGIOPLASTY, 030204 cardiovascular system & hematology, SARS-CoV-2, ST segment elevation myocardial infarction, 0302 clinical medicine, Retrospective Studie, Registries, 030212 general & internal medicine, Myocardial infarction, skin and connective tissue diseases, THROMBUS ASPIRATION, Percutaneous Coronary Intervention/adverse effects, Thrombosis(please add them), education.field_of_study, Thrombosis, 3. Good health, Treatment Outcome, Cardiology and Cardiovascular Medicine, Human, medicine.medical_specialty, Humans, Reperfusion, Retrospective Studies, COVID-19, Percutaneous Coronary Intervention, ST Elevation Myocardial Infarction, Population, Article, 03 medical and health sciences, Internal medicine, medicine, cardiovascular diseases, Platelet activation, education, METAANALYSIS, business.industry, MORTALITY, ELEVATION MYOCARDIAL-INFARCTION, Percutaneous coronary intervention, Retrospective cohort study, medicine.disease, body regions, 3121 General medicine, internal medicine and other clinical medicine, Heart failure, Conventional PCI, business
Abstract

Background and aims SARS-Cov-2 predisposes patients to thrombotic complications, due to excessive inflammation, endothelial dysfunction, platelet activation, and coagulation/fibrinolysis disturbances. The aim of the present study was to evaluate clinical characteristics and prognostic impact of SARS-CoV-2 positivity among STEMI patients undergoing primary percutaneous coronary intervention (PPCI). Methods We selected SARS-CoV-2 positive patients included in the ISACS-STEMI COVID-19, a retrospective multicenter European registry including 6609 STEMI patients treated with PPCI from March 1st until April 30th, in 2019 and 2020. As a reference group, we randomly sampled 5 SARS-Cov-2 negative patients per each SARS-CoV-2 positive patient, individually matched for age, sex, and hospital/geographic area. Study endpoints were in-hospital mortality, definite stent thrombosis, heart failure. Results Our population is represented by 62 positive SARS-CoV-2 positive patients who were compared with a matched population of 310 STEMI patients. No significant difference was observed in baseline characteristics or the modality of access to the PCI center. In the SARS-CoV-2 positive patients, the culprit lesion was more often located in the RCA (p, Graphical abstract Image 1

Published
2021

88. Impact of hypertension on mortality in patients with ST-elevation myocardial infarction undergoing primary angioplasty: insights from the international multicenter ISACS-STEMI registry.

Author

De Luca G, Nardin M, Algowhary M, Uguz B, Oliveira DC, Ganyukov V, Zimbakov Z, Cercek M, Okkels Jensen L, Loh PH, Calmac L, Roura I Ferrer G, Quadros A, Milewski M, Scotto D'Uccio F, von Birgelen C, Versaci F, Ten Berg J, Casella G, Lung AWS, Kala P, Díez Gil JL, Carrillo X, Dirksen M, Becerra-Munoz VM, Lee MK, Juzar DA, de Moura Joaquim R, Paladino R, Milicic D, Davlouros P, Bakraceski N, Zilio F, Donazzan L, Kraaijeveld A, Galasso G, Lux A, Marinucci L, Guiducci V, Menichelli M, Scoccia A, Yamac AH, Mert KU, Flores Rios X, Kovarnik T, Kidawa M, Moreu J, Flavien V, Fabris E, Lozano Martínez-Luengas I, Boccalatte M, Bosa Ojeda F, Arellano-Serrano C, Caiazzo G, Cirrincione G, Kao HL, Sanchis Forés J, Vignali L, Pereira H, Manzo S, Ordoñez S, Arat Özkan A, Scheller B, Lehtola H, Teles R, Mantis C, Antti Y, Brum Silveira JA, Zoni R, Bessonov I, Savonitto S, Kochiadakis G, Alexopulos D, Uribe CE, Kanakakis J, Faurie B, Gabrielli G, Gutierrez Barrios A, Bachini JP, Rocha A, Tam FC, Rodriguez A, Lukito AA, Saint-Joy V, Pessah G, Parodi G, Burgadha MA, Kedhi E, Lamelas P, Suryapranata H, and Verdoia M

Abstract

Background: Hypertension is the most prevalent cardiovascular risk factor, with several detrimental effects on the cardiovascular system. Contrasting results have been reported so far on its prognostic role in patients admitted for ST-segment elevation myocardial infarction (STEMI). Therefore, we investigated the impact of hypertension on short-term mortality in a large multicenter contemporary registry of STEMI patients, including patients treated during COVID-19 pandemic., Methods: The ISACS-STEMI COVID-19 was a retrospective registry that included STEMI patients treated with primary percutaneous coronary intervention (PCI) between March and June of 2019 and 2020 in 109 high-volume primary PCI centers from 4 continents. We collected data on baseline, clinical and procedural characteristics, in-hospital outcome and 30-day mortality. For this analysis patients were grouped according to history of hypertension at admission., Results: A total of 16083 patients were assessed, including 8813 (54.8%) with history of hypertension. These patients were more often elderly, with a worse cardiovascular risk profile, but were less frequently active smoker. Some procedural differences were observed between the two groups, including lower rate of thrombectomy and use of glycoprotein IIb/IIIa inhibitors or cangrelor but more extensive coronary disease in patients with hypertension. Between patients with and without hypertension, there was no significant difference in SARS-CoV-2 positivity. Hypertensive patients had a significantly higher in-hospital and 30-day mortality, similarly observed in both pre-COVID-19 and COVID-19 era, and confirmed after adjustment for main baseline differences and propensity score (in-hospital mortality: adjusted odds ratio (OR) [95% confidence interval (CI)] =1.673 [1.389-2.014], P < 0.001; 30-day mortality: adjusted hazard ratio (HR) [95% CI] = 1.418 [1.230-1.636], P < 0.001)., Conclusion: This is one of the largest and contemporary study assessing the impact of hypertension in STEMI patients undergoing primary angioplasty, including also the COVID-19 pandemic period. Hypertension was independently associated with significantly higher rates of in-hospital and 30-day mortality., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Published
2024
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89. SARS-CoV-2 Positivity, Stent Thrombosis, and 30-day Mortality in STEMI Patients Undergoing Mechanical Reperfusion.

Author

De Luca G, Algowhary M, Uguz B, Oliveira DC, Ganyukov V, Zimbakov Z, Cercek M, Okkels Jensen L, Loh PH, Calmac L, Roura I Ferrer G, Quadros A, Milewski M, Scotto Di Uccio F, von Birgelen C, Versaci F, Ten Berg J, Casella G, Wong Sung Lung A, Kala P, Díez Gil JL, Carrillo X, Dirksen M, Becerra-Munoz VM, Kang-Yin Lee M, Juzar DA, de Moura Joaquim R, De Simone C, Milicic D, Davlouros P, Bakraceski N, Zilio F, Donazzan L, Kraaijeveld A, Galasso G, Arpad L, Marinucci L, Guiducci V, Menichelli M, Scoccia A, Yamac AH, Ugur Mert K, Flores Rios X, Kovarnik T, Kidawa M, Moreu J, Flavien V, Fabris E, Lozano Martínez-Luengas I, Boccalatte M, Bosa Ojeda F, Arellano-Serrano C, Caiazzo G, Cirrincione G, Kao HL, Sanchis Forés J, Vignali L, Pereira H, Manzo-Silbermann S, Ordoñez S, Arat Özkan A, Scheller B, Lehtola H, Teles R, Mantis C, Antti Y, Brum Silveira JA, Bessonov I, Zoni R, Savonitto S, Kochiadakis G, Alexopoulos D, Uribe CE, Kanakakis J, Faurie B, Gabrielli G, Gutierrez Barrios A, Bachini JP, Rocha A, Tam FC, Rodriguez A, Lukito AA, Bellemain-Appaix A, Pessah G, Cortese G, Parodi G, Burgadha MA, Kedhi E, Lamelas P, Suryapranata H, Nardin M, and Verdoia M

Abstract

SARS-Cov-2 has been suggested to promote thrombotic complications and higher mortality. The aim of the present study was to evaluate the impact of SARS-CoV-2 positivity on in-hospital outcome and 30-day mortality in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI) enrolled in the International Survey on Acute Coronary Syndromes ST-segment elevation Myocardial Infarction (ISACS-STEMI COVID-19 registry. The 109 SARS-CoV-2 positive patients were compared with 2005 SARS-CoV-2 negative patients. Positive patients were older ( P = .002), less often active smokers ( P = .002), and hypercholesterolemic ( P = .006), they presented more often later than 12 h ( P = .037), more often to the hub and were more often in cardiogenic shock ( P = .02), or requiring rescue percutaneous coronary intervention after failed thrombolysis (P < .0001). Lower postprocedural Thrombolysis in Myocardial Infarction 3 flow ( P = .029) and more thrombectomy ( P = .046) were observed. SARS-CoV-2 was associated with a significantly higher in-hospital mortality (25.7 vs 7%, adjusted Odds Ratio (OR) [95% Confidence Interval] = 3.2 [1.71-5.99], P < .001) in-hospital definite in-stent thrombosis (6.4 vs 1.1%, adjusted Odds Ratio [95% CI] = 6.26 [2.41-16.25], P < .001) and 30-day mortality (34.4 vs 8.5%, adjusted Hazard Ratio [95% CI] = 2.16 [1.45-3.23], P < .001), confirming that SARS-CoV-2 positivity is associated with impaired reperfusion, with negative prognostic consequences., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Published
2023
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90. Age-Related Effects of COVID-19 Pandemic on Mechanical Reperfusion and 30-Day Mortality for STEMI: Results of the ISACS-STEMI COVID-19 Registry.

Author

De Luca G, Algowhary M, Uguz B, Oliveira DC, Ganyukov V, Busljetik O, Cercek M, Jensen LO, Loh PH, Calmac L, Ferrer GRI, Quadros A, Milewski M, Scotto D'Uccio F, von Birgelen C, Versaci F, Ten Berg J, Casella G, Wong Sung Lung A, Kala P, Díez Gil JL, Carrillo X, Dirksen M, Becerra Munoz V, Lee MK, Juzar DA, de Moura Joaquim R, Paladino R, Milicic D, Davlouros P, Bakraceski N, Zilio F, Donazzan L, Kraaijeveld A, Galasso G, Arpad L, Marinucci L, Guiducci V, Menichelli M, Scoccia A, Yamac AH, Ugur Mert K, Flores Rios X, Kovarnik T, Kidawa M, Moreu J, Flavien V, Fabris E, Martínez-Luengas IL, Boccalatte M, Bosa Ojeda F, Arellano-Serrano C, Caiazzo G, Cirrincione G, Kao HL, Sanchis Forés J, Vignali L, Pereira H, Manzo-Silberman S, Ordoñez S, Arat Özkan A, Scheller B, Lehitola H, Teles R, Mantis C, Antti Y, Brum Silveira JA, Zoni CR, Bessonov I, Uccello G, Kochiadakis G, Alexopulos D, Uribe CE, Kanakakis J, Faurie B, Gabrielli G, Gutierrez Barrios A, Bachini JP, Rocha A, Tam FCC, Rodriguez A, Lukito AA, Saint-Joy V, Pessah G, Tuccillo A, Ielasi A, Cortese G, Parodi G, Burgadha MA, Kedhi E, Lamelas P, Suryapranata H, Nardin M, and Verdoia M

Abstract

Background: The constraints in the management of patients with ST-segment elevation myocardial infarction (STEMI) during the COVID-19 pandemic have been suggested to have severely impacted mortality levels. The aim of the current analysis is to evaluate the age-related effects of the COVID-19 pandemic on mechanical reperfusion and 30-day mortality for STEMI within the registry ISACS-STEMI COVID-19., Methods: This retrospective multicenter registry was performed in high-volume PPCI centers on four continents and included STEMI patients undergoing PPCI in March-June 2019 and 2020. Patients were divided according to age (< or ≥75 years). The main outcomes were the incidence and timing of PPCI, (ischemia time longer than 12 h and door-to-balloon longer than 30 min), and in-hospital or 30-day mortality., Results: We included 16,683 patients undergoing PPCI in 109 centers. In 2020, during the pandemic, there was a significant reduction in PPCI as compared to 2019 (IRR 0.843 (95%-CI: 0.825-0.861, p < 0.0001). We found a significant age-related reduction (7%, p = 0.015), with a larger effect on elderly than on younger patients. Furthermore, we observed significantly higher 30-day mortality during the pandemic period, especially among the elderly (13.6% vs. 17.9%, adjusted HR (95% CI) = 1.55 [1.24-1.93], p < 0.001) as compared to younger patients (4.8% vs. 5.7%; adjusted HR (95% CI) = 1.25 [1.05-1.49], p = 0.013), as a potential consequence of the significantly longer ischemia time observed during the pandemic., Conclusions: The COVID-19 pandemic had a significant impact on the treatment of patients with STEMI, with a 16% reduction in PPCI procedures, with a larger reduction and a longer delay to treatment among elderly patients, which may have contributed to increase in-hospital and 30-day mortality during the pandemic.

Published
2023
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91. Gender Difference in the Effects of COVID-19 Pandemic on Mechanical Reperfusion and 30-Day Mortality for STEMI: Results of the ISACS-STEMI COVID-19 Registry.

Author

De Luca G, Manzo-Silberman S, Algowhary M, Uguz B, Oliveira DC, Ganyukov V, Busljetik O, Cercek M, Okkels L, Loh PH, Calmac L, Ferrer GRI, Quadros A, Milewski M, Scotto di Uccio F, von Birgelen C, Versaci F, Ten Berg J, Casella G, Wong Sung Lung A, Kala P, Díez Gil JL, Carrillo X, Dirksen M, Becerra V, Lee MK, Juzar DA, de Moura Joaquim R, Paladino R, Milicic D, Davlouros P, Bakraceski N, Zilio F, Donazzan L, Kraaijeveld A, Galasso G, Arpad L, Marinucci L, Guiducci V, Menichelli M, Scoccia A, Yamac AH, Ugur Mert K, Flores Rios X, Kovarnik T, Kidawa M, Moreu J, Flavien V, Fabris E, Martínez-Luengas IL, Boccalatte M, Ojeda FB, Arellano-Serrano C, Caiazzo G, Cirrincione G, Kao HL, Forés JS, Vignali L, Pereira H, Ordoñez S, Arat Özkan A, Scheller B, Lehtola H, Teles R, Mantis C, Antti Y, Brum Silveira JA, Zoni CR, Bessonov I, Uccello G, Kochiadakis G, Alexopulos D, Uribe CE, Kanakakis J, Faurie B, Gabrielli G, Barrios AG, Bachini JP, Rocha A, Tam FCC, Rodriguez A, Lukito AA, Saint-Joy V, Pessah G, Tuccillo A, Ielasi A, Cortese G, Parodi G, Bouraghda MA, Moura M, Kedhi E, Lamelas P, Suryapranata H, Nardin M, and Verdoia M

Abstract

Background: Several reports have demonstrated the impact of the COVID-19 pandemic on the management and outcome of patients with ST-segment elevation myocardial infarction (STEMI). The aim of the current analysis is to investigate the potential gender difference in the effects of the COVID-19 pandemic on mechanical reperfusion and 30-day mortality for STEMI patients within the ISACS-STEMI COVID-19 Registry., Methods: This retrospective multicenter registry was performed in high-volume primary percutaneous coronary intervention (PPCI) centers on four continents and included STEMI patients undergoing PPCIs in March-June 2019 and 2020. Patients were divided according to gender. The main outcomes were the incidence and timing of the PPCI, (ischemia time ≥ 12 h and door-to-balloon ≥ 30 min) and in-hospital or 30-day mortality., Results: We included 16683 STEMI patients undergoing PPCIs in 109 centers. In 2020 during the pandemic, there was a significant reduction in PPCIs compared to 2019 (IRR 0.843 (95% CI: 0.825-0.861, p < 0.0001). We did not find a significant gender difference in the effects of the COVID-19 pandemic on the numbers of STEMI patients, which were similarly reduced from 2019 to 2020 in both groups, or in the mortality rates. Compared to prepandemia, 30-day mortality was significantly higher during the pandemic period among female (12.1% vs. 8.7%; adjusted HR [95% CI] = 1.66 [1.31-2.11], p < 0.001) but not male patients (5.8% vs. 6.7%; adjusted HR [95% CI] = 1.14 [0.96-1.34], p = 0.12)., Conclusions: The COVID-19 pandemic had a significant impact on the treatment of patients with STEMI, with a 16% reduction in PPCI procedures similarly observed in both genders. Furthermore, we observed significantly increased in-hospital and 30-day mortality rates during the pandemic only among females. Trial registration number: NCT 04412655.

Published
2023
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92. Impact of Smoking Status on Mortality in STEMI Patients Undergoing Mechanical Reperfusion for STEMI: Insights from the ISACS-STEMI COVID-19 Registry.

Author

De Luca G, Algowhary M, Uguz B, Oliveira DC, Ganyukov V, Zimbakov Z, Cercek M, Jensen LO, Loh PH, Calmac L, Ferrer GRI, Quadros A, Milewski M, Scotto D'Uccio F, von Birgelen C, Versaci F, Ten Berg J, Casella G, Wong Sung Lung A, Kala P, Díez Gil JL, Carrillo X, Dirksen M, Becerra-Munoz VM, Lee MK, Juzar DA, Joaquim RM, Paladino R, Milicic D, Davlouros P, Bakraceski N, Zilio F, Donazzan L, Kraaijeveld A, Galasso G, Arpad L, Lucia M, Vincenzo G, Menichelli M, Scoccia A, Yamac AH, Ugur Mert K, Flores Rios X, Kovarnik T, Kidawa M, Moreu J, Vincent F, Fabris E, Martínez-Luengas IL, Boccalatte M, Bosa Ojeda F, Arellano-Serrano C, Caiazzo G, Cirrincione G, Kao HL, Sanchis Forés J, Vignali L, Pereira H, Manzo S, Ordoñez S, Özkan AA, Scheller B, Lehtola H, Teles R, Mantis C, Antti Y, Silveira JAB, Zoni R, Bessonov I, Savonitto S, Kochiadakis G, Alexopulos D, Uribe CE, Kanakakis J, Faurie B, Gabrielli G, Barrios AG, Bachini JP, Rocha A, Tam FC, Rodriguez A, Lukito AA, Saint-Joy V, Pessah G, Tuccillo A, Cortese G, Parodi G, Bouraghda MA, Kedhi E, Lamelas P, Suryapranata H, Nardin M, and Verdoia M

Abstract

The so-called “smoking paradox”, conditioning lower mortality in smokers among STEMI patients, has seldom been addressed in the settings of modern primary PCI protocols. The ISACS−STEMI COVID-19 is a large-scale retrospective multicenter registry addressing in-hospital mortality, reperfusion, and 30-day mortality among primary PCI patients in the era of the COVID-19 pandemic. Among the 16,083 STEMI patients, 6819 (42.3%) patients were active smokers, 2099 (13.1%) previous smokers, and 7165 (44.6%) non-smokers. Despite the impaired preprocedural recanalization (p < 0.001), active smokers had a significantly better postprocedural TIMI flow compared with non-smokers (p < 0.001); this was confirmed after adjustment for all baseline and procedural confounders, and the propensity score. Active smokers had a significantly lower in-hospital (p < 0.001) and 30-day (p < 0.001) mortality compared with non-smokers and previous smokers; this was confirmed after adjustment for all baseline and procedural confounders, and the propensity score. In conclusion, in our population, active smoking was significantly associated with improved epicardial recanalization and lower in-hospital and 30-day mortality compared with previous and non-smoking history.

Published
2022
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93. Impact of chronic obstructive pulmonary disease on short-term outcome in patients with ST-elevation myocardial infarction during COVID-19 pandemic: insights from the international multicenter ISACS-STEMI registry.

Author

De Luca G, Nardin M, Algowhary M, Uguz B, Oliveira DC, Ganyukov V, Zimbakov Z, Cercek M, Okkels Jensen L, Loh PH, Calmac L, Roura Ferrer G, Quadros A, Milewski M, Scotto di Uccio F, von Birgelen C, Versaci F, Ten Berg J, Casella G, Wong Sung Lung A, Kala P, Díez Gil JL, Carrillo X, Dirksen M, Becerra-Munoz VM, Lee MK, Arifa Juzar D, de Moura Joaquim R, Paladino R, Milicic D, Davlouros P, Bakraceski N, Zilio F, Donazzan L, Kraaijeveld A, Galasso G, Lux A, Marinucci L, Guiducci V, Menichelli M, Scoccia A, Yamac AH, Ugur Mert K, Flores Rios X, Kovarnik T, Kidawa M, Moreu J, Flavien V, Fabris E, Martínez-Luengas IL, Boccalatte M, Bosa Ojeda F, Arellano-Serrano C, Caiazzo G, Cirrincione G, Kao HL, Sanchis Forés J, Vignali L, Pereira H, Manzo S, Ordoñez S, Özkan AA, Scheller B, Lehtola H, Teles R, Mantis C, Antti Y, Brum Silveira JA, Zoni R, Bessonov I, Savonitto S, Kochiadakis G, Alexopoulos D, Uribe CE, Kanakakis J, Faurie B, Gabrielli G, Gutierrez Barrios A, Bachini JP, Rocha A, Tam FC, Rodriguez A, Lukito AA, Saint-Joy V, Pessah G, Tuccillo A, Cortese G, Parodi G, Bouraghda MA, Kedhi E, Lamelas P, Suryapranata H, and Verdoia M

Subjects
Aged, Hospital Mortality, Humans, Pandemics, Registries, Retrospective Studies, SARS-CoV-2, Treatment Outcome, COVID-19 epidemiology, Percutaneous Coronary Intervention adverse effects, Pulmonary Disease, Chronic Obstructive diagnosis, Pulmonary Disease, Chronic Obstructive epidemiology, Pulmonary Disease, Chronic Obstructive therapy, ST Elevation Myocardial Infarction diagnosis, ST Elevation Myocardial Infarction epidemiology, ST Elevation Myocardial Infarction therapy
Abstract

Background: Chronic obstructive pulmonary disease (COPD) is projected to become the third cause of mortality worldwide. COPD shares several pathophysiological mechanisms with cardiovascular disease, especially atherosclerosis. However, no definite answers are available on the prognostic role of COPD in the setting of ST elevation myocardial infarction (STEMI), especially during COVID-19 pandemic, among patients undergoing primary angioplasty, that is therefore the aim of the current study., Methods: In the ISACS-STEMI COVID-19 registry we included retrospectively patients with STEMI treated with primary percutaneous coronary intervention (PCI) between March and June of 2019 and 2020 from 109 high-volume primary PCI centers in 4 continents., Results: A total of 15,686 patients were included in this analysis. Of them, 810 (5.2%) subjects had a COPD diagnosis. They were more often elderly and with a more pronounced cardiovascular risk profile. No preminent procedural dissimilarities were noticed except for a lower proportion of dual antiplatelet therapy at discharge among COPD patients (98.9% vs. 98.1%, P = 0.038). With regards to short-term fatal outcomes, both in-hospital and 30-days mortality occurred more frequently among COPD patients, similarly in pre-COVID-19 and COVID-19 era. However, after adjustment for main baseline differences, COPD did not result as independent predictor for in-hospital death (adjusted OR [95% CI] = 0.913[0.658-1.266], P = 0.585) nor for 30-days mortality (adjusted OR [95% CI] = 0.850 [0.620-1.164], P = 0.310). No significant differences were detected in terms of SARS-CoV-2 positivity between the two groups., Conclusion: This is one of the largest studies investigating characteristics and outcome of COPD patients with STEMI undergoing primary angioplasty, especially during COVID pandemic. COPD was associated with significantly higher rates of in-hospital and 30-days mortality. However, this association disappeared after adjustment for baseline characteristics. Furthermore, COPD did not significantly affect SARS-CoV-2 positivity., Trial Registration Number: NCT04412655 (2nd June 2020)., (© 2022. The Author(s).)

Published
2022
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94. Renin-angiotensin system inhibitors and mortality among diabetic patients with STEMI undergoing mechanical reperfusion during the COVID-19 pandemic.

Author

De Luca G, Nardin M, Algowhary M, Uguz B, Oliveira DC, Ganyukov V, Zimbakov Z, Cercek M, Jensen LO, Loh PH, Calmac L, Roura Ferrer G, Quadros A, Milewski M, Scotto di Uccio F, von Birgelen C, Versaci F, Ten Berg J, Casella G, Lung AWS, Kala P, Díez Gil JL, Carrillo X, Dirksen M, Becerra-Munoz VM, Lee MK, Juzar DA, de Moura Joaquim R, Paladino R, Milicic D, Davlouros P, Bakraceski N, Zilio F, Donazzan L, Kraaijeveld A, Galasso G, Lux A, Marinucci L, Guiducci V, Menichelli M, Scoccia A, Yamac AH, Mert KU, Flores Rios X, Kovarnik T, Kidawa M, Moreu J, Flavien V, Fabris E, Martínez-Luengas IL, Boccalatte M, Bosa Ojeda F, Arellano-Serrano C, Caiazzo G, Cirrincione G, Kao HL, Sanchis Forés J, Vignali L, Pereira H, Manzo S, Ordoñez S, Arat Özkan A, Scheller B, Lehtola H, Teles R, Mantis C, Antti Y, Brum Silveira JA, Zoni R, Bessonov I, Savonitto S, Kochiadakis G, Alexopulos D, Uribe CE, Kanakakis J, Faurie B, Gabrielli G, Gutierrez Barrios A, Bachini JP, Rocha A, Tam FC, Rodriguez A, Lukito AA, Saint-Joy V, Pessah G, Tuccillo A, Cortese G, Parodi G, Bouraghda MA, Kedhi E, Lamelas P, Suryapranata H, and Verdoia M

Abstract

Background: During the coronavirus disease 2019 (COVID-19) pandemic, concerns have been arisen on the use of renin-angiotensin system inhibitors (RASI) due to the potentially increased expression of Angiotensin-converting-enzyme (ACE)2 and patient's susceptibility to SARS-CoV2 infection. Diabetes mellitus have been recognized favoring the coronavirus infection with consequent increase mortality in COVID-19. No data have been so far reported in diabetic patients suffering from ST-elevation myocardial infarction (STEMI), a very high-risk population deserving of RASI treatment., Methods: The ISACS-STEMI COVID-19 registry retrospectively assessed STEMI patients treated with primary percutaneous coronary intervention (PPCI) in March/June 2019 and 2020 in 109 European high-volume primary PCI centers. This subanalysis assessed the prognostic impact of chronic RASI therapy at admission on mortality and SARS-CoV2 infection among diabetic patients., Results: Our population is represented by 3812 diabetic STEMI patients undergoing mechanical reperfusion, 2038 in 2019 and 1774 in 2020. Among 3761 patients with available data on chronic RASI therapy, between those ones with and without treatment there were several differences in baseline characteristics, (similar in both periods) but no difference in the prevalence of SARS-CoV2 infection (1.6% vs 1.3%, respectively, p  = 0.786). Considering in-hospital medication, RASI therapy was overall associated with a significantly lower in-hospital mortality (3.3% vs 15.8%, p  < 0.0001), consistently both in 2019 and in 2010., Conclusions: This is first study to investigate the impact of RASI therapy on prognosis and SARS-CoV2 infection of diabetic patients experiencing STEMI and undergoing PPCI during the COVID-19 pandemic. Both pre-admission chronic RASI therapy and in-hospital RASI did not negatively affected patients' survival during the hospitalization, neither increased the risk of SARS-CoV2 infection., Trial Registration Number: NCT04412655., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2021 Published by Elsevier Masson SAS.)

Published
2021
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95. Impact of SARS-CoV-2 positivity on clinical outcome among STEMI patients undergoing mechanical reperfusion: Insights from the ISACS STEMI COVID 19 registry.

Author

De Luca G, Debel N, Cercek M, Jensen LO, Vavlukis M, Calmac L, Johnson T, Ferrer GR, Ganyukov V, Wojakowski W, Kinnaird T, von Birgelen C, Cottin Y, IJsselmuiden A, Tuccillo B, Versaci F, Royaards KJ, Berg JT, Laine M, Dirksen M, Siviglia M, Casella G, Kala P, Díez Gil JL, Banning A, Becerra V, De Simone C, Santucci A, Carrillo X, Scoccia A, Amoroso G, Van't Hof AW, Kovarnik T, Tsigkas G, Mehilli J, Gabrielli G, Rios XF, Bakraceski N, Levesque S, Cirrincione G, Guiducci V, Kidawa M, Spedicato L, Marinucci L, Ludman P, Zilio F, Galasso G, Fabris E, Menichelli M, Garcia-Touchard A, Manzo S, Caiazzo G, Moreu J, Forés JS, Donazzan L, Vignali L, Teles R, Benit E, Agostoni P, Ojeda FB, Lehtola H, Camacho-Freiere S, Kraaijeveld A, Antti Y, Boccalatte M, Deharo P, Martínez-Luengas IL, Scheller B, Varytimiadi E, Moreno R, Uccello G, Faurie B, Gutierrez Barrios A, Milewski M, Bruwiere E, Smits P, Wilbert B, Di Uccio FS, Parodi G, Kedhi E, and Verdoia M

Subjects
Humans, Registries, Reperfusion, Retrospective Studies, SARS-CoV-2, Treatment Outcome, COVID-19, Percutaneous Coronary Intervention adverse effects, ST Elevation Myocardial Infarction diagnosis, ST Elevation Myocardial Infarction surgery
Abstract

Background and Aims: SARS-Cov-2 predisposes patients to thrombotic complications, due to excessive inflammation, endothelial dysfunction, platelet activation, and coagulation/fibrinolysis disturbances. The aim of the present study was to evaluate clinical characteristics and prognostic impact of SARS-CoV-2 positivity among STEMI patients undergoing primary percutaneous coronary intervention (PPCI)., Methods: We selected SARS-CoV-2 positive patients included in the ISACS-STEMI COVID-19, a retrospective multicenter European registry including 6609 STEMI patients treated with PPCI from March 1st until April 30th, in 2019 and 2020. As a reference group, we randomly sampled 5 SARS-Cov-2 negative patients per each SARS-CoV-2 positive patient, individually matched for age, sex, and hospital/geographic area. Study endpoints were in-hospital mortality, definite stent thrombosis, heart failure., Results: Our population is represented by 62 positive SARS-CoV-2 positive patients who were compared with a matched population of 310 STEMI patients. No significant difference was observed in baseline characteristics or the modality of access to the PCI center. In the SARS-CoV-2 positive patients, the culprit lesion was more often located in the RCA (p < 0.001). Despite similar pre and postprocedural TIMI flow, we observed a trend in higher use of GP IIb-IIIa inhibitors and a significantly higher use of thrombectomy in the SARS-CoV-2 positive patients. SARS-CoV-2 positivity was associated with a remarkably higher in hospital mortality (29% vs 5.5%, p < 0.001), definite in-stent thrombosis (8.1% vs 1.6%, p = 0.004) and heart failure (22.6% vs 10.6%, p = 0.001) that was confirmed after adjustment for confounding factors., Conclusions: Our study showed that among STEMI patients, SARS-CoV-2 positivity is associated with larger thrombus burden, a remarkably higher mortality but also higher rates of in-stent thrombosis and heart failure., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Published
2021
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96. Impact of renin-angiotensin system inhibitors on mortality during the COVID Pandemic among STEMI patients undergoing mechanical reperfusion: Insight from an international STEMI registry.

Author

De Luca G, Cercek M, Okkels Jensen L, Bushljetikj O, Calmac L, Johnson T, Gracida Blancas M, Ganyukov V, Wojakowski W, von Birgelen C, IJsselmuiden A, Tuccillo B, Versaci F, Ten Berg J, Laine M, Berkout T, Casella G, Kala P, López Ledesma B, Becerra V, Padalino R, Santucci A, Carrillo X, Scoccia A, Amoroso G, Lux A, Kovarnik T, Davlouros P, Gabrielli G, Flores Rios X, Bakraceski N, Levesque S, Guiducci V, Kidawa M, Marinucci L, Zilio F, Galasso G, Fabris E, Menichelli M, Manzo S, Caiazzo G, Moreu J, Sanchis Forés J, Donazzan L, Vignali L, Teles R, Agostoni P, Bosa Ojeda F, Lehtola H, Camacho-Freiere S, Kraaijeveld A, Antti Y, Visconti G, Lozano Martínez-Luengas I, Scheller B, Alexopulos D, Moreno R, Kedhi E, Uccello G, Faurie B, Gutierrez Barrios A, Scotto Di Uccio F, Wilbert B, Cortese G, Dirksen MT, Parodi G, and Verdoia M

Subjects
Aged, COVID-19 therapy, Female, Hospitalization, Humans, Male, Middle Aged, Pandemics, Percutaneous Coronary Intervention, Prognosis, Registries, Renin-Angiotensin System, ST Elevation Myocardial Infarction therapy, COVID-19 Drug Treatment, Antihypertensive Agents therapeutic use, COVID-19 mortality, Myocardial Reperfusion, SARS-CoV-2, ST Elevation Myocardial Infarction mortality
Abstract

Background: Concerns have been raised on a potential interaction between renin-angiotensin system inhibitors (RASI) and the susceptibility to coronavirus disease 2019 (COVID-19). No data have been so far reported on the prognostic impact of RASI in patients suffering from ST-elevation myocardial infarction (STEMI) during COVID-19 pandemic, which was the aim of the present study., Methods: STEMI patients treated with primary percutaneous coronary intervention (PPCI) and enrolled in the ISACS-STEMI COVID-19 registry were included in the present sub-analysis and divided according to RASI therapy at admission., Results: Our population is represented by 6095 patients, of whom 3654 admitted in 2019 and 2441 in 2020. No difference in the prevalence of SARSCoV2 infection was observed according to RASI therapy at admission (2.5% vs 2.1%, p = 0.5), which was associated with a significantly lower mortality (adjusted OR [95% CI]=0.68 [0.51-0.90], P = 0.006), confirmed in the analysis restricted to 2020 (adjusted OR [95% CI]=0.5[0.33-0.74], P = 0.001). Among the 5388 patients in whom data on in-hospital medication were available, in-hospital RASI therapy was associated with a significantly lower mortality (2.1% vs 16.7%, OR [95% CI]=0.11 [0.084-0.14], p < 0.0001), confirmed after adjustment in both periods. Among the 62 SARSCoV-2 positive patients, RASI therapy, both at admission or in-hospital, showed no prognostic effect., Conclusions: This is the first study to investigate the impact of RASI therapy on the prognosis and SARSCoV2 infection of STEMI patients undergoing PPCI during the COVID-19 pandemic. Both pre-admission and in-hospital RASI were associated with lower mortality. Among SARSCoV2-positive patients, both chronic and in-hospital RASI therapy showed no impact on survival., (Copyright © 2021 The Authors. Published by Elsevier Masson SAS.. All rights reserved.)

Published
2021
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97. Outcome of extracorporeal membrane oxygenation support for high-risk percutaneous coronary intervention in non-ST-segment elevation acute coronary syndrome.

Author

Ganyukov V, Sucato V, Vereshchagin I, Kochergin N, Tarasov R, Shukevic D, Shilov A, Ganyukov I, Kornelyuk R, Diana D, Vadala G, and Galassi AR

Subjects
Aged, Comorbidity, Female, Humans, Male, Outcome and Process Assessment, Health Care, Patient Selection, Postoperative Complications diagnosis, Postoperative Complications epidemiology, Risk Assessment methods, Russia epidemiology, Severity of Illness Index, Survival Analysis, Ventricular Dysfunction, Left diagnosis, Ventricular Dysfunction, Left epidemiology, Coronary Occlusion diagnostic imaging, Extracorporeal Membrane Oxygenation adverse effects, Extracorporeal Membrane Oxygenation methods, Hemorrhage etiology, Hemorrhage prevention & control, Non-ST Elevated Myocardial Infarction diagnosis, Non-ST Elevated Myocardial Infarction mortality, Non-ST Elevated Myocardial Infarction physiopathology, Non-ST Elevated Myocardial Infarction surgery, Percutaneous Coronary Intervention adverse effects, Percutaneous Coronary Intervention methods, Risk Adjustment methods
Published
2021
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98. Mechanism of Vascular Injury in Transcatheter Aortic Valve Replacement.

Author

Ovcharenko EA, Klyshnikov KU, Shilov AA, Kochergin NA, Rezvova MA, Belikov NV, and Ganyukov VI

Subjects
Aortic Valve surgery, Humans, Aortic Valve Stenosis surgery, Heart Valve Prosthesis, Transcatheter Aortic Valve Replacement adverse effects, Vascular System Injuries surgery
Abstract

The aim of the study was to determine the potential mechanism of vascular complications due to "catheter-vascular wall" interaction in transcatheter aortic valve replacement using experimental and numerical analysis., Materials and Methods: A series of full-scale bench tests and numerical simulations were carried out using the CoreValve commercial transfemoral delivery system for aortic valve bioprosthesis (Medtronic Inc., USA). Full-scale tests were carried out using a phantom of the vascular system (a polymeric silicone model of Transcatheter Aortic Valve; Trandomed 3D Inc., China) with simulation of all stages of delivery system movement along the vascular bed. They involved introduction into the common femoral artery, movement along the abdominal and thoracic parts of the aorta, the aortic arch, and positioning the system to the implantation site. The force arising from the passage of the delivery system was assessed using sensors of a Z50 universal testing machine (Zwick/Roell, Germany). Numerical simulation of transcatheter valve replacement procedure was carried out in a similar way with allowance for the patient-specific anatomy of the recipient's aorta using the finite element method in the Abaqus/CAE environment (Dassault Systèmes, France)., Results: It was found that in the process of the delivery system passing through the vascular system, there occurred force fluctuations associated with catheter bending and its interaction with the aortic wall in the region of its arch. For example, in the initial straight portions, the pushing force was 3.8-7.9 N; the force increased to the maximum (11.1 and 14.4 N with and without the prosthesis) with bending of the distal portion of the catheter. A similar increase was observed when performing numerical simulation with high-quality graphic visualization of stress on the "spots" of contact between the catheter and the vascular wall with an increase in stress to 0.8 MPa., Conclusion: Numerical and full-scale bench tests prove the significant effect of the properties of delivery system catheter for transcatheter aortic valve replacement on the interaction with the aortic walls., Competing Interests: Conflicts of interest. There are no conflicts of interest related to this study.

Published
2021
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99. Impact of COVID-19 pandemic and diabetes on mechanical reperfusion in patients with STEMI: insights from the ISACS STEMI COVID 19 Registry.

Author

De Luca G, Cercek M, Jensen LO, Vavlukis M, Calmac L, Johnson T, Roura I Ferrer G, Ganyukov V, Wojakowski W, von Birgelen C, Versaci F, Ten Berg J, Laine M, Dirksen M, Casella G, Kala P, Díez Gil JL, Becerra V, De Simone C, Carrill X, Scoccia A, Lux A, Kovarnik T, Davlouros P, Gabrielli G, Flores Rios X, Bakraceski N, Levesque S, Guiducci V, Kidawa M, Marinucci L, Zilio F, Galasso G, Fabris E, Menichelli M, Manzo S, Caiazzo G, Moreu J, Sanchis Forés J, Donazzan L, Vignali L, Teles R, Bosa Ojeda F, Lehtola H, Camacho-Freiere S, Kraaijeveld A, Antti Y, Boccalatte M, Martínez-Luengas IL, Scheller B, Alexopoulos D, Uccello G, Faurie B, Gutierrez Barrios A, Wilbert B, Cortese G, Moreno R, Parodi G, Kedhi E, and Verdoia M

Subjects
Aged, COVID-19 diagnosis, COVID-19 mortality, Diabetes Mellitus diagnosis, Diabetes Mellitus mortality, Europe epidemiology, Female, Hospital Mortality trends, Humans, Hypertension epidemiology, Male, Middle Aged, Percutaneous Coronary Intervention adverse effects, Percutaneous Coronary Intervention mortality, Registries, Retrospective Studies, Risk Factors, ST Elevation Myocardial Infarction mortality, Time Factors, Treatment Outcome, COVID-19 epidemiology, Diabetes Mellitus epidemiology, Percutaneous Coronary Intervention trends, ST Elevation Myocardial Infarction therapy, Time-to-Treatment trends
Abstract

Background: It has been suggested the COVID pandemic may have indirectly affected the treatment and outcome of STEMI patients, by avoidance or significant delays in contacting the emergency system. No data have been reported on the impact of diabetes on treatment and outcome of STEMI patients, that was therefore the aim of the current subanalysis conducted in patients included in the International Study on Acute Coronary Syndromes-ST Elevation Myocardial Infarction (ISACS-STEMI) COVID-19., Methods: The ISACS-STEMI COVID-19 is a retrospective registry performed in European centers with an annual volume of > 120 primary percutaneous coronary intervention (PCI) and assessed STEMI patients, treated with primary PCI during the same periods of the years 2019 versus 2020 (March and April). Main outcomes are the incidences of primary PCI, delayed treatment, and in-hospital mortality., Results: A total of 6609 patients underwent primary PCI in 77 centers, located in 18 countries. Diabetes was observed in a total of 1356 patients (20.5%), with similar proportion between 2019 and 2020. During the pandemic, there was a significant reduction in primary PCI as compared to 2019, similar in both patients with (Incidence rate ratio (IRR) 0.79 (95% CI: 0.73-0.85, p < 0.0001) and without diabetes (IRR 0.81 (95% CI: 0.78-0.85, p < 0.0001) (p int = 0.40). We observed a significant heterogeneity among centers in the population with and without diabetes (p < 0.001, respectively). The heterogeneity among centers was not related to the incidence of death due to COVID-19 in both groups of patients. Interaction was observed for Hypertension (p = 0.024) only in absence of diabetes. Furthermore, the pandemic was independently associated with a significant increase in door-to-balloon and total ischemia times only among patients without diabetes, which may have contributed to the higher mortality, during the pandemic, observed in this group of patients., Conclusions: The COVID-19 pandemic had a significant impact on the treatment of patients with STEMI, with a similar reduction in primary PCI procedures in both patients with and without diabetes. Hypertension had a significant impact on PCI reduction only among patients without diabetes. We observed a significant increase in ischemia time and door-to-balloon time mainly in absence of diabetes, that contributed to explain the increased mortality observed in this group of patients during the pandemic., Trial Registration Number: NCT04412655.

Published
2020
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100. Systematic investment in the delivery of guideline-coherent therapy reduces mortality and overall costs in patients with ST-elevation myocardial infarction: Results from the Stent for Life economic model for Romania, Portugal, Basque Country and Kemerovo region.

Author

Wein B, Bashkireva A, Au-Yeung A, Yoculan A, Vinereanu D, Deleanu D, Pereira H, Pereira E, de Mello S, Rumoroso JR, Ganyukov V, Wijns W, and Naber CK

Subjects
Cost Savings, Humans, Percutaneous Coronary Intervention methods, Portugal epidemiology, Risk Factors, Romania epidemiology, Russia epidemiology, ST Elevation Myocardial Infarction economics, ST Elevation Myocardial Infarction mortality, Spain epidemiology, Survival Rate trends, Time Factors, Treatment Outcome, Models, Economic, Patient Compliance, Percutaneous Coronary Intervention economics, Registries, ST Elevation Myocardial Infarction therapy, Stents
Abstract

Aims: The Stent for Life initiative aims at the reduction of mortality in patients with ST-elevation myocardial infarction by enhancing timely access to primary percutaneous coronary intervention. To assess the associated health and socioeconomic impact, the Stent for Life economic project was launched and applied to four model regions: Romania, Portugal, the Basque Country in Spain, and the Kemerovo region in the Russian Federation., Methods and Results: The Stent for Life economic model is based on a decision tree that incorporates primary percutaneous coronary intervention rates and mortality. Healthcare costs and indirect costs caused by loss of productivity were estimated. A baseline scenario simulating the status quo was compared to the Stent for Life scenario which integrated changes initiated by the Stent for Life programme. In the four model regions, primary percutaneous coronary intervention numbers rose substantially between 29-303%, while ST-elevation myocardial infarction mortality was reduced between 3-10%. Healthcare costs increased by 8% to 70%. Indirect cost savings ranged from 2-7%. Net societal costs were reduced in all model regions by 2-4%., Conclusion: The joint effort of the Stent for Life initiative and their local partners successfully saves lives. Moreover, the increase in healthcare costs was outweighed by indirect cost savings, leading to a net cost reduction in all four model regions. These findings demonstrate that systematic investments to improve the access of ST-elevation myocardial infarction patients to guideline-coherent therapy is beneficial, not only for the individual, but also for the society at large.

Published
2020
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