Impact of COVID-19 pandemic on STEMI care: An expanded analysis from the United States

Santiago Garcia; Larissa Stanberry; Christian Schmidt; Scott Sharkey; Michael Megaly; Mazen S. Albaghdadi; Perwaiz M. Meraj; Ross Garberich; Farouc A. Jaffer; Ada C. Stefanescu Schmidt; Simon R. Dixon; Jeffrey J. Rade; Timothy Smith; Mark Tannenbaum; Jenny Chambers; Frank Aguirre; Paul P. Huang; Dharam J. Kumbhani; Thomas Koshy; Dmitriy N. Feldman; Jay Giri; Prashant Kaul; Craig Thompson; Houman Khalili; Brij Maini; Keshav R. Nayak; Mauricio G. Cohen; Sripal Bangalore; Binita Shah; Timothy D. Henry

doi:10.1002/ccd.29154

Impact of COVID-19 pandemic on STEMI care: An expanded analysis from the United States

Santiago Garcia, Larissa Stanberry, Christian Schmidt, Scott Sharkey, Michael Megaly, Mazen S. Albaghdadi, Perwaiz M. Meraj, Ross Garberich, Farouc A. Jaffer, Ada C. Stefanescu Schmidt, Simon R. Dixon, Jeffrey J. Rade, Timothy Smith, Mark Tannenbaum, Jenny Chambers, Frank Aguirre, Paul P. Huang, Dharam J. Kumbhani, Thomas Koshy, Dmitriy N. FeldmanJay Giri, Prashant Kaul, Craig Thompson, Houman Khalili, Brij Maini, Keshav R. Nayak, Mauricio G. Cohen, Sripal Bangalore, Binita Shah, Timothy D. Henry

Research output: Contribution to journal › Article › peer-review

2 Scopus citations

Abstract

Objective: To evaluate the impact of COVID-19 pandemic migitation measures on of ST-elevation myocardial infarction (STEMI) care. Background: We previously reported a 38% decline in cardiac catheterization activations during the early phase of the COVID-19 pandemic mitigation measures. This study extends our early observations using a larger sample of STEMI programs representative of different US regions with the inclusion of more contemporary data. Methods: Data from 18 hospitals or healthcare systems in the US from January 2019 to April 2020 were collecting including number activations for STEMI, the number of activations leading to angiography and primary percutaneous coronary intervention (PPCI), and average door to balloon (D2B) times. Two periods, January 2019–February 2020 and March–April 2020, were defined to represent periods before (BC) and after (AC) initiation of pandemic mitigation measures, respectively. A generalized estimating equations approach was used to estimate the change in response variables at AC from BC. Results: Compared to BC, the AC period was characterized by a marked reduction in the number of activations for STEMI (29%, 95% CI:18–38, p <.001), number of activations leading to angiography (34%, 95% CI: 12–50, p =.005) and number of activations leading to PPCI (20%, 95% CI: 11–27, p <.001). A decline in STEMI activations drove the reductions in angiography and PPCI volumes. Relative to BC, the D2B times in the AC period increased on average by 20%, 95%CI (−0.2 to 44, p =.05). Conclusions: The COVID-19 Pandemic has adversely affected many aspects of STEMI care, including timely access to the cardiac catheterization laboratory for PPCI.

Original language	English (US)
Journal	Catheterization and Cardiovascular Interventions
DOIs	https://doi.org/10.1002/ccd.29154
State	Accepted/In press - 2020

Keywords

COVID-19
ST-elevation myocardial infarction
STEMI

ASJC Scopus subject areas

Radiology Nuclear Medicine and imaging
Cardiology and Cardiovascular Medicine

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Garcia, S., Stanberry, L., Schmidt, C., Sharkey, S., Megaly, M., Albaghdadi, M. S., Meraj, P. M., Garberich, R., Jaffer, F. A., Stefanescu Schmidt, A. C., Dixon, S. R., Rade, J. J., Smith, T., Tannenbaum, M., Chambers, J., Aguirre, F., Huang, P. P., Kumbhani, D. J., Koshy, T., ... Henry, T. D. (Accepted/In press). Impact of COVID-19 pandemic on STEMI care: An expanded analysis from the United States. Catheterization and Cardiovascular Interventions. https://doi.org/10.1002/ccd.29154

Impact of COVID-19 pandemic on STEMI care : An expanded analysis from the United States. / Garcia, Santiago; Stanberry, Larissa; Schmidt, Christian; Sharkey, Scott; Megaly, Michael; Albaghdadi, Mazen S.; Meraj, Perwaiz M.; Garberich, Ross; Jaffer, Farouc A.; Stefanescu Schmidt, Ada C.; Dixon, Simon R.; Rade, Jeffrey J.; Smith, Timothy; Tannenbaum, Mark; Chambers, Jenny; Aguirre, Frank; Huang, Paul P.; Kumbhani, Dharam J.; Koshy, Thomas; Feldman, Dmitriy N.; Giri, Jay; Kaul, Prashant; Thompson, Craig; Khalili, Houman; Maini, Brij; Nayak, Keshav R.; Cohen, Mauricio G.; Bangalore, Sripal; Shah, Binita; Henry, Timothy D.

In: Catheterization and Cardiovascular Interventions, 2020.

Research output: Contribution to journal › Article › peer-review

Garcia, S, Stanberry, L, Schmidt, C, Sharkey, S, Megaly, M, Albaghdadi, MS, Meraj, PM, Garberich, R, Jaffer, FA, Stefanescu Schmidt, AC, Dixon, SR, Rade, JJ, Smith, T, Tannenbaum, M, Chambers, J, Aguirre, F, Huang, PP, Kumbhani, DJ , Koshy, T, Feldman, DN, Giri, J, Kaul, P, Thompson, C, Khalili, H, Maini, B, Nayak, KR, Cohen, MG, Bangalore, S, Shah, B & Henry, TD 2020, 'Impact of COVID-19 pandemic on STEMI care: An expanded analysis from the United States', Catheterization and Cardiovascular Interventions. https://doi.org/10.1002/ccd.29154

Garcia, Santiago ; Stanberry, Larissa ; Schmidt, Christian ; Sharkey, Scott ; Megaly, Michael ; Albaghdadi, Mazen S. ; Meraj, Perwaiz M. ; Garberich, Ross ; Jaffer, Farouc A. ; Stefanescu Schmidt, Ada C. ; Dixon, Simon R. ; Rade, Jeffrey J. ; Smith, Timothy ; Tannenbaum, Mark ; Chambers, Jenny ; Aguirre, Frank ; Huang, Paul P. ; Kumbhani, Dharam J. ; Koshy, Thomas ; Feldman, Dmitriy N. ; Giri, Jay ; Kaul, Prashant ; Thompson, Craig ; Khalili, Houman ; Maini, Brij ; Nayak, Keshav R. ; Cohen, Mauricio G. ; Bangalore, Sripal ; Shah, Binita ; Henry, Timothy D. / Impact of COVID-19 pandemic on STEMI care : An expanded analysis from the United States. In: Catheterization and Cardiovascular Interventions. 2020.

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title = "Impact of COVID-19 pandemic on STEMI care: An expanded analysis from the United States",

abstract = "Objective: To evaluate the impact of COVID-19 pandemic migitation measures on of ST-elevation myocardial infarction (STEMI) care. Background: We previously reported a 38% decline in cardiac catheterization activations during the early phase of the COVID-19 pandemic mitigation measures. This study extends our early observations using a larger sample of STEMI programs representative of different US regions with the inclusion of more contemporary data. Methods: Data from 18 hospitals or healthcare systems in the US from January 2019 to April 2020 were collecting including number activations for STEMI, the number of activations leading to angiography and primary percutaneous coronary intervention (PPCI), and average door to balloon (D2B) times. Two periods, January 2019–February 2020 and March–April 2020, were defined to represent periods before (BC) and after (AC) initiation of pandemic mitigation measures, respectively. A generalized estimating equations approach was used to estimate the change in response variables at AC from BC. Results: Compared to BC, the AC period was characterized by a marked reduction in the number of activations for STEMI (29%, 95% CI:18–38, p <.001), number of activations leading to angiography (34%, 95% CI: 12–50, p =.005) and number of activations leading to PPCI (20%, 95% CI: 11–27, p <.001). A decline in STEMI activations drove the reductions in angiography and PPCI volumes. Relative to BC, the D2B times in the AC period increased on average by 20%, 95%CI (−0.2 to 44, p =.05). Conclusions: The COVID-19 Pandemic has adversely affected many aspects of STEMI care, including timely access to the cardiac catheterization laboratory for PPCI.",

keywords = "COVID-19, ST-elevation myocardial infarction, STEMI",

author = "Santiago Garcia and Larissa Stanberry and Christian Schmidt and Scott Sharkey and Michael Megaly and Albaghdadi, {Mazen S.} and Meraj, {Perwaiz M.} and Ross Garberich and Jaffer, {Farouc A.} and {Stefanescu Schmidt}, {Ada C.} and Dixon, {Simon R.} and Rade, {Jeffrey J.} and Timothy Smith and Mark Tannenbaum and Jenny Chambers and Frank Aguirre and Huang, {Paul P.} and Kumbhani, {Dharam J.} and Thomas Koshy and Feldman, {Dmitriy N.} and Jay Giri and Prashant Kaul and Craig Thompson and Houman Khalili and Brij Maini and Nayak, {Keshav R.} and Cohen, {Mauricio G.} and Sripal Bangalore and Binita Shah and Henry, {Timothy D.}",

note = "Funding Information: The regional STEMI program at Abbott Northwestern Hospital is supported by the Minneapolis Heart Institute Foundation and Allina Health. ",

year = "2020",

doi = "10.1002/ccd.29154",

language = "English (US)",

journal = "Catheterization and Cardiovascular Interventions",

issn = "1522-1946",

publisher = "Wiley-Liss Inc.",

}

TY - JOUR

T1 - Impact of COVID-19 pandemic on STEMI care

T2 - An expanded analysis from the United States

AU - Garcia, Santiago

AU - Stanberry, Larissa

AU - Schmidt, Christian

AU - Sharkey, Scott

AU - Megaly, Michael

AU - Albaghdadi, Mazen S.

AU - Meraj, Perwaiz M.

AU - Garberich, Ross

AU - Jaffer, Farouc A.

AU - Stefanescu Schmidt, Ada C.

AU - Dixon, Simon R.

AU - Rade, Jeffrey J.

AU - Smith, Timothy

AU - Tannenbaum, Mark

AU - Chambers, Jenny

AU - Aguirre, Frank

AU - Huang, Paul P.

AU - Kumbhani, Dharam J.

AU - Koshy, Thomas

AU - Feldman, Dmitriy N.

AU - Giri, Jay

AU - Kaul, Prashant

AU - Thompson, Craig

AU - Khalili, Houman

AU - Maini, Brij

AU - Nayak, Keshav R.

AU - Cohen, Mauricio G.

AU - Bangalore, Sripal

AU - Shah, Binita

AU - Henry, Timothy D.

N1 - Funding Information: The regional STEMI program at Abbott Northwestern Hospital is supported by the Minneapolis Heart Institute Foundation and Allina Health.

PY - 2020

Y1 - 2020

N2 - Objective: To evaluate the impact of COVID-19 pandemic migitation measures on of ST-elevation myocardial infarction (STEMI) care. Background: We previously reported a 38% decline in cardiac catheterization activations during the early phase of the COVID-19 pandemic mitigation measures. This study extends our early observations using a larger sample of STEMI programs representative of different US regions with the inclusion of more contemporary data. Methods: Data from 18 hospitals or healthcare systems in the US from January 2019 to April 2020 were collecting including number activations for STEMI, the number of activations leading to angiography and primary percutaneous coronary intervention (PPCI), and average door to balloon (D2B) times. Two periods, January 2019–February 2020 and March–April 2020, were defined to represent periods before (BC) and after (AC) initiation of pandemic mitigation measures, respectively. A generalized estimating equations approach was used to estimate the change in response variables at AC from BC. Results: Compared to BC, the AC period was characterized by a marked reduction in the number of activations for STEMI (29%, 95% CI:18–38, p <.001), number of activations leading to angiography (34%, 95% CI: 12–50, p =.005) and number of activations leading to PPCI (20%, 95% CI: 11–27, p <.001). A decline in STEMI activations drove the reductions in angiography and PPCI volumes. Relative to BC, the D2B times in the AC period increased on average by 20%, 95%CI (−0.2 to 44, p =.05). Conclusions: The COVID-19 Pandemic has adversely affected many aspects of STEMI care, including timely access to the cardiac catheterization laboratory for PPCI.

AB - Objective: To evaluate the impact of COVID-19 pandemic migitation measures on of ST-elevation myocardial infarction (STEMI) care. Background: We previously reported a 38% decline in cardiac catheterization activations during the early phase of the COVID-19 pandemic mitigation measures. This study extends our early observations using a larger sample of STEMI programs representative of different US regions with the inclusion of more contemporary data. Methods: Data from 18 hospitals or healthcare systems in the US from January 2019 to April 2020 were collecting including number activations for STEMI, the number of activations leading to angiography and primary percutaneous coronary intervention (PPCI), and average door to balloon (D2B) times. Two periods, January 2019–February 2020 and March–April 2020, were defined to represent periods before (BC) and after (AC) initiation of pandemic mitigation measures, respectively. A generalized estimating equations approach was used to estimate the change in response variables at AC from BC. Results: Compared to BC, the AC period was characterized by a marked reduction in the number of activations for STEMI (29%, 95% CI:18–38, p <.001), number of activations leading to angiography (34%, 95% CI: 12–50, p =.005) and number of activations leading to PPCI (20%, 95% CI: 11–27, p <.001). A decline in STEMI activations drove the reductions in angiography and PPCI volumes. Relative to BC, the D2B times in the AC period increased on average by 20%, 95%CI (−0.2 to 44, p =.05). Conclusions: The COVID-19 Pandemic has adversely affected many aspects of STEMI care, including timely access to the cardiac catheterization laboratory for PPCI.

KW - COVID-19

KW - ST-elevation myocardial infarction

KW - STEMI

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