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1. 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

Luca, G. De, 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., otto di Uccio, F. Sc, Birgelen, C. von, Versaci, F., Berg, J ., Casella, G., Wong Sung Lung, A., Kala, P., Díez Gil, J.L., Carrillo, X., Dirksen, M., Becerra, V., Lee, M.K., Juzar, D.A., Moura Joaquim, R. de, 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., Martínez-Luengas, I.L., Boccalatte, M., Ojeda, F.B., Arellano-Serrano, C., Caiazzo, G., Cirrincione, G., Kao, H.L., Forés, J.S., Vignali, L., Pereira, H., Ordoñez, S., Arat Özkan, 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., 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., Verdoia, M., Luca, G. De, 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., otto di Uccio, F. Sc, Birgelen, C. von, Versaci, F., Berg, J ., Casella, G., Wong Sung Lung, A., Kala, P., Díez Gil, J.L., Carrillo, X., Dirksen, M., Becerra, V., Lee, M.K., Juzar, D.A., Moura Joaquim, R. de, 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., Martínez-Luengas, I.L., Boccalatte, M., Ojeda, F.B., Arellano-Serrano, C., Caiazzo, G., Cirrincione, G., Kao, H.L., Forés, J.S., Vignali, L., Pereira, H., Ordoñez, S., Arat Özkan, 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., 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.

Abstract

Item does not contain fulltext, 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

2. 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

Luca, G. De, Algowhary, M., Uguz, B., Oliveira, D.C., Ganyukov, V., Busljetik, O., Cercek, M., Jensen, L.O., Loh, P.H., Calmac, L., Ferrer, G.R.I., Quadros, A., Milewski, M., Scotto D'Uccio, F., Birgelen, C. von, Versaci, F., Berg, J ., Casella, G., Wong Sung Lung, A., Kala, P., Díez Gil, J.L., Carrillo, X., Dirksen, M., Becerra Munoz, V., Lee, M.K., Juzar, D.A., Moura Joaquim, R. de, 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., Martínez-Luengas, I.L., Boccalatte, M., Bosa Ojeda, F., Arellano-Serrano, C., Caiazzo, G., Cirrincione, G., Kao, H.L., 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, J.A., Zoni, C.R., Bessonov, I., Uccello, G., Kochiadakis, G., Alexopulos, D., Uribe, C.E., Kanakakis, J., Faurie, B., Gabrielli, G., Gutierrez Barrios, A., Bachini, J.P., Rocha, Alex, Tam, F.C., Rodriguez, A., Lukito, A.A., Saint-Joy, V., Pessah, G., Tuccillo, A., Ielasi, A., Cortese, G., Parodi, G., Burgadha, M.A., Kedhi, E., Lamelas, P., Suryapranata, H., Nardin, M., Verdoia, M., Luca, G. De, Algowhary, M., Uguz, B., Oliveira, D.C., Ganyukov, V., Busljetik, O., Cercek, M., Jensen, L.O., Loh, P.H., Calmac, L., Ferrer, G.R.I., Quadros, A., Milewski, M., Scotto D'Uccio, F., Birgelen, C. von, Versaci, F., Berg, J ., Casella, G., Wong Sung Lung, A., Kala, P., Díez Gil, J.L., Carrillo, X., Dirksen, M., Becerra Munoz, V., Lee, M.K., Juzar, D.A., Moura Joaquim, R. de, 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., Martínez-Luengas, I.L., Boccalatte, M., Bosa Ojeda, F., Arellano-Serrano, C., Caiazzo, G., Cirrincione, G., Kao, H.L., 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, J.A., Zoni, C.R., Bessonov, I., Uccello, G., Kochiadakis, G., Alexopulos, D., Uribe, C.E., Kanakakis, J., Faurie, B., Gabrielli, G., Gutierrez Barrios, A., Bachini, J.P., Rocha, Alex, Tam, F.C., Rodriguez, A., Lukito, A.A., Saint-Joy, V., Pessah, G., Tuccillo, A., Ielasi, A., Cortese, G., Parodi, G., Burgadha, M.A., Kedhi, E., Lamelas, P., Suryapranata, H., Nardin, M., and Verdoia, M.

Abstract

Contains fulltext : 291566.pdf (Publisher’s version ) (Open Access), 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

4. COVID-19 pandemic, mechanical reperfusion and 30-day mortality in ST elevation myocardial infarction

Author

De Luca G, 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, Wong ASL, Kala P, Diez Gil JL, Carrillo X, Dirksen MT, Becerra-Muñoz VM, Kang-Yin Lee M, Juzar DA, de Moura Joaquim R, Paladino R, Milicic D, Davlouros P, Bakraceski N, Zilio F, Donazzan L, Kraaijeveld AO, Galasso G, Lux A, Marinucci L, Guiducci V, Menichelli M, Scoccia A, Yamac A, Ugur Mert K, Flores Rios X, Kovarnik T, Kidawa M, Moreu J, Flavien V, Fabris E, Lozano Martìnez-Luengas I, Boccalatte M, Bosa Ojeda F, Arellano-Serrano C, Caiazzo G, Cirrincione G, Kao HL, Sanchis Fores J, Vignali L, Pereira H, Manzo-Silberman S, Ordonez S, Özkan AA, Scheller B, Lehtola H, Teles R, Mantis C, Ylitalo A, Brum Silveira JA, Zoni R, Bessonov I, Savonitto S, Kochiadakis G, Alexopoulos D, Uribe C, Kanakakis J, Faurie B, Gabrielli G, Gutiérrez A, Bachini JP, Rocha A, Tam FC, Rodriguez A, Lukito A, Saint-Joy V, Pessah G, Tuccillo B, Cortese G, Parodi G, Bouraghda MA, Kedhi E, Lamelas P, Suryapranata H, Nardin M, Verdoia M, ISACS-STEMI COVID-19, Collaborators, RS: Carim - H01 Clinical atrial fibrillation, Cardiologie, De Luca, G., Algowhary, M., Uguz, B., Oliveira, D. C., Ganyukov, V., Zimbakov, Z., Cercek, M., Jensen, L. O., 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, A. S. L., Kala, P., Diez Gil, J. L., Carrillo, X., Dirksen, M. T., Becerra-Munoz, V. M., Kang-Yin Lee, M., Juzar, D. A., de Moura Joaquim, R., Paladino, R., Milicic, D., Davlouros, P., Bakraceski, N., Zilio, F., Donazzan, L., Kraaijeveld, A. O., Galasso, G., Lux, A., Marinucci, L., Guiducci, V., Menichelli, M., Scoccia, A., Yamac, A., Ugur Mert, K., Flores Rios, X., Kovarnik, T., Kidawa, M., Moreu, J., Flavien, V., Fabris, E., Lozano Martinez-Luengas, I., Boccalatte, M., Bosa Ojeda, F., Arellano-Serrano, C., Caiazzo, G., Cirrincione, G., Kao, H. -L., Sanchis Fores, J., Vignali, L., Pereira, H., Manzo-Silberman, S., Ordonez, S., Ozkan, A. A., Scheller, B., Lehtola, H., Teles, R., Mantis, C., Ylitalo, A., Brum Silveira, J. A., Zoni, R., Bessonov, I., Savonitto, S., Kochiadakis, G., Alexopoulos, D., Uribe, C., Kanakakis, J., Faurie, B., Gabrielli, G., Gutierrez, A., Bachini, J. P., Rocha, A., Tam, F. C., Rodriguez, A., Lukito, A., Saint-Joy, V., Pessah, G., Tuccillo, B., Cortese, G., Parodi, G., Bouraghda, M. A., Kedhi, E., Lamelas, P., Suryapranata, H., Nardin, M., and Verdoia, M.

Subjects
Registrie, Male, ST Elevation Myocardial Infarction/diagnosis, Time Factors, Percutaneous, medicine.medical_treatment, Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], Coronary Artery Disease, Practice Patterns, 030204 cardiovascular system & hematology, Rate ratio, Time-to-Treatment/trends, Cardiologists, 0302 clinical medicine, Retrospective Studie, Heart Rate, Risk Factors, Pandemic, ST segment, Registries, Hospital Mortality, 030212 general & internal medicine, Myocardial infarction, Practice Patterns, Physicians', 10. No inequality, Percutaneous Coronary Intervention/adverse effects, Hospital Mortality/trends, COVID-19, myocardial infarction, percutaneous coronary intervention, Incidence, Incidence (epidemiology), Middle Aged, 3. Good health, Treatment Outcome, Cardiology, Female, Cardiology and Cardiovascular Medicine, Cardiologists/trends, Human, Aged, Humans, Percutaneous Coronary Intervention, Retrospective Studies, Risk Assessment, ST Elevation Myocardial Infarction, Time-to-Treatment, medicine.medical_specialty, Time Factor, Coronavirus disease 2019 (COVID-19), Cardiologist, 03 medical and health sciences, Internal medicine, medicine, Acute Coronary Syndrome, Pandemics, Physicians', SARS-CoV-2, business.industry, Risk Factor, COVID-19, myocardial infarction, percutaneous coronary intervention, Percutaneous coronary intervention, medicine.disease, Practice Patterns, Physicians'/trends, business
Abstract

ObjectiveThe initial data of the International Study on Acute Coronary Syndromes - ST Elevation Myocardial Infarction COVID-19 showed in Europe a remarkable reduction in primary percutaneous coronary intervention procedures and higher in-hospital mortality during the initial phase of the pandemic as compared with the prepandemic period. The aim of the current study was to provide the final results of the registry, subsequently extended outside Europe with a larger inclusion period (up to June 2020) and longer follow-up (up to 30 days).MethodsThis is a retrospective multicentre registry in 109 high-volume primary percutaneous coronary intervention (PPCI) centres from Europe, Latin America, South-East Asia and North Africa, enrolling 16 674 patients with ST segment elevation myocardial infarction (STEMI) undergoing PPPCI in March/June 2019 and 2020. The main study outcomes were the incidence of PPCI, delayed treatment (ischaemia time >12 hours and door-to-balloon >30 min), in-hospital and 30-day mortality.ResultsIn 2020, during the pandemic, there was a significant reduction in PPCI as compared with 2019 (incidence rate ratio 0.843, 95% CI 0.825 to 0.861, p75 years) (p=0.015), and was not related to the peak of cases or deaths due to COVID-19. The heterogeneity among centres was high (pConclusionPercutaneous revascularisation for STEMI was significantly affected by the COVID-19 pandemic, with a 16% reduction in PPCI procedures, especially among older patients (about 20%), and longer delays to treatment, which may have contributed to the increased in-hospital and 30-day mortality during the pandemic.Trial registration numberNCT04412655.

Published
2022
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5. COVID-19 pandemic, mechanical reperfusion and 30-day mortality in ST elevation myocardial infarction

Author

Luca, G. De, Algowhary, M., Uguz, B., Oliveira, D.C., Ganyukov, V., Zimbakov, Z., Cercek, M., Jensen, L.O., Loh, P.H., Calmac, L., Roura-Ferrer, G., Quadros, A., Milewski, M., Uccio, F. Scotto di, Birgelen, C. von, Versaci, F., Berg, J ., Casella, G., Wong, A.S.Y., Kala, P., Gil, J.L. Diez, Carrillo, X., Dirksen, M.T., Becerra-Muñoz, V.M., Kang-Yin Lee, M., Juzar, D.A., Joaquim, R. de Moura, Paladino, R., Milicic, D., Davlouros, P., Bakraceski, N., Zilio, F., Donazzan, L., Kraaijeveld, A.O., Galasso, G., Lux, A, Marinucci, L., Guiducci, V., Menichelli, M., Scoccia, A., Yamac, A., Mert, K. Ugur, Rios, X. Flores, Kovarnik, T., Kidawa, M., Moreu, J., Flavien, V., Fabris, E., Martìnez-Luengas, I. Lozano, Boccalatte, M., Ojeda, F., Arellano-Serrano, C., Caiazzo, G., Cirrincione, G., Kao, H.L., Fores, J. Sanchis, Vignali, L., Pereira, H., Manzo-Silberman, S., Ordonez, S., Özkan, A.A., Scheller, B., Lehtola, H., Teles, R., Mantis, C., Ylitalo, A., Silveira, J.A. Brum, Zoni, R., Bessonov, I., Savonitto, S., Kochiadakis, G., Alexopoulos, D., Uribe, C., Kanakakis, J., Faurie, B., Gabrielli, G., Gutiérrez, A., Bachini, J.P., Rocha, A., Tam, F.C., Rodriguez, A., Lukito, A., Saint-Joy, V., Pessah, G., Tuccillo, B., Cortese, G., Parodi, G., Bouraghda, M.A., Kedhi, E., Lamelas, P., Suryapranata, H., Nardin, M., Verdoia, M., Luca, G. De, Algowhary, M., Uguz, B., Oliveira, D.C., Ganyukov, V., Zimbakov, Z., Cercek, M., Jensen, L.O., Loh, P.H., Calmac, L., Roura-Ferrer, G., Quadros, A., Milewski, M., Uccio, F. Scotto di, Birgelen, C. von, Versaci, F., Berg, J ., Casella, G., Wong, A.S.Y., Kala, P., Gil, J.L. Diez, Carrillo, X., Dirksen, M.T., Becerra-Muñoz, V.M., Kang-Yin Lee, M., Juzar, D.A., Joaquim, R. de Moura, Paladino, R., Milicic, D., Davlouros, P., Bakraceski, N., Zilio, F., Donazzan, L., Kraaijeveld, A.O., Galasso, G., Lux, A, Marinucci, L., Guiducci, V., Menichelli, M., Scoccia, A., Yamac, A., Mert, K. Ugur, Rios, X. Flores, Kovarnik, T., Kidawa, M., Moreu, J., Flavien, V., Fabris, E., Martìnez-Luengas, I. Lozano, Boccalatte, M., Ojeda, F., Arellano-Serrano, C., Caiazzo, G., Cirrincione, G., Kao, H.L., Fores, J. Sanchis, Vignali, L., Pereira, H., Manzo-Silberman, S., Ordonez, S., Özkan, A.A., Scheller, B., Lehtola, H., Teles, R., Mantis, C., Ylitalo, A., Silveira, J.A. Brum, Zoni, R., Bessonov, I., Savonitto, S., Kochiadakis, G., Alexopoulos, D., Uribe, C., Kanakakis, J., Faurie, B., Gabrielli, G., Gutiérrez, A., Bachini, J.P., Rocha, A., Tam, F.C., Rodriguez, A., Lukito, A., Saint-Joy, V., Pessah, G., Tuccillo, B., Cortese, G., Parodi, G., Bouraghda, M.A., Kedhi, E., Lamelas, P., Suryapranata, H., Nardin, M., and Verdoia, M.

Abstract

Item does not contain fulltext, OBJECTIVE: The initial data of the International Study on Acute Coronary Syndromes - ST Elevation Myocardial Infarction COVID-19 showed in Europe a remarkable reduction in primary percutaneous coronary intervention procedures and higher in-hospital mortality during the initial phase of the pandemic as compared with the prepandemic period. The aim of the current study was to provide the final results of the registry, subsequently extended outside Europe with a larger inclusion period (up to June 2020) and longer follow-up (up to 30 days). METHODS: This is a retrospective multicentre registry in 109 high-volume primary percutaneous coronary intervention (PPCI) centres from Europe, Latin America, South-East Asia and North Africa, enrolling 16 674 patients with ST segment elevation myocardial infarction (STEMI) undergoing PPPCI in March/June 2019 and 2020. The main study outcomes were the incidence of PPCI, delayed treatment (ischaemia time >12 hours and door-to-balloon >30 min), in-hospital and 30-day mortality. RESULTS: In 2020, during the pandemic, there was a significant reduction in PPCI as compared with 2019 (incidence rate ratio 0.843, 95% CI 0.825 to 0.861, p<0.0001). This reduction was significantly associated with age, being higher in older adults (>75 years) (p=0.015), and was not related to the peak of cases or deaths due to COVID-19. The heterogeneity among centres was high (p<0.001). Furthermore, the pandemic was associated with a significant increase in door-to-balloon time (40 (25-70) min vs 40 (25-64) min, p=0.01) and total ischaemia time (225 (135-410) min vs 196 (120-355) min, p<0.001), which may have contributed to the higher in-hospital (6.5% vs 5.3%, p<0.001) and 30-day (8% vs 6.5%, p=0.001) mortality observed during the pandemic. CONCLUSION: Percutaneous revascularisation for STEMI was significantly affected by the COVID-19 pandemic, with a 16% reduction in PPCI procedures, especially among older patients (about 20%), and longer delays to treatmen

Published
2022

7. 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

8. 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
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9. 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, 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

Subjects
Humans, Male, Female, Aged, Middle Aged, Retrospective Studies, Hospital Mortality, Risk Factors, SARS-CoV-2, ST Elevation Myocardial Infarction mortality, ST Elevation Myocardial Infarction complications, ST Elevation Myocardial Infarction therapy, Hypertension complications, Hypertension mortality, Registries, COVID-19 complications, COVID-19 mortality, Percutaneous Coronary Intervention
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
2025
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10. Implementation of a Virtual Cardiology Curriculum to Address the Deficit of Cardiovascular Education in Haiti.

Author

Sibindi C, Saint-Joy V, Ibrahim M, Domond K, Tierney A, Loubeau B, Calixte D, and Haynes N

Abstract

Background: Cardiovascular disease (CVD) is the leading cause of death in low- and middle-income countries such as Haiti. Our team has demonstrated in a pilot study the implementation of a virtual cardiology curriculum to address the deficit of cardiology education in Haiti among medicine residents., Objectives: The objective of this study was to determine if cardiology education can be delivered nationwide in Haiti via a virtual platform with quantifiable improvement., Methods: Over 1 academic year, we recruited internal medicine residents from all residency years and all 4 of the internal medicine training programs in Haiti. They were enrolled in a trimester curriculum of biweekly, synchronous and asynchronous didactic lectures, seminars, and case presentations delivered via an interactive virtual classroom. Pre-trimester and post-trimester assessments were delivered to the students. Knowledge acquisition was analyzed by way of Cohen's r effect sizes with 0.1 to <0.3 interpreted as small, 0.3 to <0.5 as moderate, and >0.5 as large., Results: A total of 62 residents were enrolled, 26 in their first year, 21 in their second, and 15 in their third year. There was significant improvement in CVD knowledge with all residency classes showing moderate to large effect sizes. There were notable differences in the effect sizes for residency programs in different locations. There was also significant student attrition over time likely due, in part, to political instability., Conclusions: This study demonstrates that it is possible to virtually deliver cardiology education to trainees in low- and middle-income countries on a national scale to address the deficit of CVD education. Aside from uncontrollable factors like political instability, attrition can be improved by formalization of the curriculum., Competing Interests: The authors have reported that they have no relationships relevant to the contents of this paper to disclose., (© 2024 The Authors.)

Published
2024
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11. Survival and predictors of mortality in patients with heart failure in the cardiology department of the Center Hospitalier Basse Terre in Guadeloupe: historical cohort study.

Author

Mumbulu ET, Nkodila AN, Saint-Joy V, Moussinga N, Makulo JR, and Buila NB

Subjects
Humans, Male, Female, Aged, Risk Factors, Aged, 80 and over, Time Factors, Middle Aged, Risk Assessment, Prognosis, Guadeloupe epidemiology, Cause of Death, Cardiology Service, Hospital, Retrospective Studies, Acute Disease, Hospital Mortality, Shock, Cardiogenic mortality, Shock, Cardiogenic diagnosis, Shock, Cardiogenic therapy, Shock, Cardiogenic physiopathology, Heart Failure mortality, Heart Failure diagnosis
Abstract

Background: Despite the progress made in recent years in the treatment of Acute Heart Failure (AHF), its prognosis remains poor in the developing country. The objective of this study is to analyze the survival and predictors of mortality of patients with acute heart failure in the cardiology department of the Basse Terre Hospital Center in Guadeloupe., Methods: this was a historical cohort study carried out over a period from June 2021 to June 2022, targeting all acute heart failure patients undergoing cardiac monitoring in the cardiology department of the Basse Terre Hospital Center in Guadeloupe. Sociodemographic, clinical, biological characteristics and outcome (recovery or death) were studied. Survival was described using the Kaplan Meier method α = 5%., Results: this study involved 242 acute heart failure patients whose median age was 75 years and the majority were male (sex ratio 2 M/1F). Among these patients, 14.9% died, the most common cause of death was cardiogenic shock (52.8%). After adjustment, tobacco consumption (aHR: 2.90; 95% CI: 1.36-8.09), Chronic Kidney Disease (aHR: 2.52; 95% CI: 1.22-5.20), infection (aHR: 2.14; 95CI %: 1.99-4.58), hyponatremia (aHR: 1.90; 95% CI: 1.10-2.86), mitral regurgitation (aHR: 3.04; 95% CI: 1.98-9.47) and N-terminal pro Brain Natriuretic Peptide > 10000ng/ml (aHR: 2.57; 95% CI: 1.21-5.49) were independently associated with the risk of death in heart failure patients., Conclusion: Acute heart failure leads to high mortality, mainly due to cardiogenic shock and factors of multiple organ failure., (© 2024. The Author(s).)

Published
2024
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12. Education and Training Models for Remote Learning.

Author

Forbes VE, Chamberlin MD, Dusabejambo V, Walker T, Bensen SP, Haynes N, Nunes K, Saint-Joy V, and Makrauer FL

Subjects
Education, Distance, Models, Educational
Abstract

Our international partnerships have fostered longstanding collaborative relationships leading to the development of unique, locally-designed, and sustainable training programs that serve as models for global health education and cooperation., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Published
2024
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13. 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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14. 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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15. 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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16. 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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17. Implementation of a virtual international cardiology curriculum to address the deficit of cardiovascular education in Haiti: a pilot study.

Author

Haynes NA, Saint-Joy V, Swain J, Ezekwesili A, Vernet FV, Dawson C, Laneau D, Tierney A, Shea JA, and Ambrose MS

Subjects
Curriculum, Haiti, Humans, Pandemics, Pilot Projects, SARS-CoV-2, COVID-19, Cardiology education
Abstract

Background: Cardiovascular disease (CVD) remains a leading cause of morbidity and mortality worldwide, conferring a disparate burden on low-income and middle-income countries (LMICs). Haiti represents a resource-constrained setting, limited by a paucity of resources and trained cardiovascular professionals equipped to address the increasing burden of CVD., Objective: Here, we describe the creation of a comprehensive cardiology curriculum delivered through a virtual classroom. The curriculum was created to augment cardiovascular education in LMICs such as Haiti., Methods: Over one academic year (May 2019-2020), International Cardiology Curriculum Accessible by Remote Distance Learning-Haiti consisted of biweekly, live-streamed, synchronous didactic lectures, seminars and case presentations broadcasted to 16 internal medicine (IM) residents at Hôpital Universitaire de Mirebalais, one of only four IM training programmes in Haiti. The virtual classroom was created using commercially available videoconferencing and data-sharing platforms. Prelecture and postlecture surveys and an end of the year survey were administered to assess the impact of the curriculum., Results: Participant performance analysis revealed that 80% of the curriculum demonstrated a positive trend in knowledge acquisition postintervention. Based on the end of the year evaluation, 94% of participants reported that the curriculum was educational and relevant to medical practice in Haiti and 100% reported that the curriculum was good to excellent. Additionally, the curriculum was cited as an effective means of maintaining trainee education during the COVID-19 pandemic., Conclusion: This international medical education pilot study demonstrates the feasibility of augmenting cardiology education in LMICs by creating a virtual curriculum made possible by local partnerships, internet access and technology., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Published
2021
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18. Global Health Imperative to Prioritizing Cardiovascular Education.

Author

Haynes N, Saint-Joy V, and Swain J

Subjects
Cardiologists education, Cardiovascular Diseases therapy, Global Health, Haiti, Humans, International Cooperation, Cardiology education
Abstract

Competing Interests: Funding Support and Author Disclosures The authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Published
2021
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19. Teaching Neuro Images : Fahr syndrome caused by hypoparathyroidism.

Author

Dade E, Saint-Joy V, Haynes NA, and Berkowitz AL

Subjects
Basal Ganglia Diseases surgery, Calcinosis surgery, Child, Female, Humans, Hypoparathyroidism diagnostic imaging, Neurodegenerative Diseases surgery, Basal Ganglia Diseases diagnostic imaging, Basal Ganglia Diseases etiology, Calcinosis diagnostic imaging, Calcinosis etiology, Hypoparathyroidism complications, Magnetic Resonance Imaging, Neurodegenerative Diseases diagnostic imaging, Neurodegenerative Diseases etiology
Published
2017
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