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De Luca, Giuseppe; Verdoia, Monica; Cercek, Miha; Jensen, Lisette Okkels; Vavlukis, Marija; Calmac, Lucian; Johnson, Tom; Ferrer, Gerard Rourai; Ganyukov, Vladimir; Wojakowski, Wojtek; Kinnaird, Tim; Birgelen, Clemens van; Cottin, Yves; IJsselmuiden, Alexander; Tuccillo, Bernardo; Versaci, Francesco; Royaards, Kees-Jan; Ten Berg, Jurrien; Laine, Mika; Dirksen, Maurits; Siviglia, Massimo; Casella, Gianni; Kala, Petr; Diez Gil, Jose Luis; Banning, Adrian; Becerra, Victor; De Simone, Ciro; Santucci, Andrea; Carrillo, Xavier; Scoccia, Alessandra; Amoroso, Giovanni; Lux, Arpad; Kovarnik, Tomas; Davlouros, Periklis; Mehilli, Julinda; Gabrielli, Gabriele; Rios, Xacobe Flores; Bakraceski, Nikola; Levesque, Sebastien; Cirrincione, Giuseppe; Guiducci, Vincenzo; Kidawa, Michal; Spedicato, Leonardo; Marinucci, Lucia; Ludman, Peter; Zilio, Filippo; Galasso, Gennaro; Fabris, Enrico; Menichelli, Maurizio; Garcia-Touchard, Arturo; Manzo, Stephane; Caiazzo, Gianluca; Moreu, Jose; Sanchis Fores, Juan; Donazzan, Luca; Vignali, Luigi; Teles, Rui; Benit, Edouard; Agostoni, Pierfrancesco; Bosa Ojeda, Francisco; Lehtola, Heidi; Camacho-Freiere, Santiago; Kraaijeveld, Adriaan; Antti, Ylitalo; Boccalatte, Marco; Deharo, Pierre; Lozano Martinez-Luengas, Inigo; Scheller, Bruno; Alexopoulos, Dimitrios; Moreno, Raul; Kedhi, Elvin; Uccello, Giuseppe; Faurie, Benjamin; Gutierrez Barrios, Alejandro; Di Uccio, Fortunato Scotto; Wilbert, Bor; Smits, Pieter; Cortese, Giuliana; Parodi, Guido and Dudek, Dariusz (2020): Impact of COVID-19 Pandemic on Mechanical Reperfusion for Patients With STEMI. In: Journal of the American College of Cardiology, Vol. 76, No. 20: pp. 2321-2330

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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 < 0.0001). The heterogeneity among centers was not related to the incidence of death due to COVID-19. A significant interaction was observed for patients with arterial hypertension, who were less frequently admitted in 2020 than in 2019. Furthermore, the pandemic was associated with a significant increase in door-to-balloon and total ischemia times, which may have contributed to the higher mortality during the pandemic. CONCLUSIONS The COVID-19 pandemic had significant impact on the treatment of patients with STEMI, with a 19% reduction in PPCI procedures, especially among patients suffering from hypertension, and a longer delay to treatment, which may have contributed to the increased mortality during the pandemic. (C) 2020 by the American College of Cardiology Foundation.

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