Case Selection During the COVID-19 Pandemic: Who Should Go to the Cardiac Catheterization Laboratory?

Evangelia Vemmou, Ilias Nikolakopoulos, Emmanouil S. Brilakis, Payam Dehghani, Santiago Garcia

Research output: Contribution to journalReview articlepeer-review

Abstract

Purpose of review: To summarize the best available evidence and recommendations regarding case selection for cardiac catheterization laboratory (CCL) during the coronavirus disease 2019 (COVID-19) pandemic with emphasis on ST segment elevation myocardial infarction (STEMI) management. Recent findings: The restructuring of cardiovascular services to preserve hospital beds and personal protective equipment during the COVID-19 pandemic had a profound effect on healthcare delivery around the world with unintended consequences. In the United States, a significant 38% reduction in CCL activations for STEMI was noted in the early phase of the pandemic. Similarly, a 34% decline in utilization of invasive angiography, an 18% reduction in primary percutaneous coronary intervention (PPCI), and a 19% increase in door-to-balloon (D2B) times were also observed. These trends coincided with a significant increase in out-of-hospital cardiac arrests and late MI presentations. A shift to pharmacological reperfusion has been advocated in Asia, which resulted in increased morbidity and mortality. Summary: COVID-19 has negatively affected many aspects of STEMI care, including timely access to mechanical reperfusion, which has resulted in increased morbidity and mortality. Balancing optimal STEMI care with the risk of infection to healthcare workers during the pandemic is challenging. Recommendations provided by consensus documents are a helpful guidance.

Original languageEnglish (US)
Article number27
JournalCurrent Treatment Options in Cardiovascular Medicine
Volume23
Issue number4
DOIs
StatePublished - Apr 2021
Externally publishedYes

Keywords

  • COVID-19
  • Cardiac catheterization

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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