Impact of the COVID-19 Pandemic on Door-to-Balloon Time for Primary Percutaneous Coronary Intervention　― Results From the Singapore Western STEMI Network ―

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  • Chew Nicholas WS
    Department of Cardiology, National University Heart Centre, National University Health System
  • Sia Ching-Hui
    Department of Cardiology, National University Heart Centre, National University Health System Yong Loo Lin School of Medicine, National University of Singapore
  • Wee Hwee-Lin
    Saw Swee Hock School of Public Health, National University of Singapore
  • Benedict Loh Jia-Da
    Saw Swee Hock School of Public Health, National University of Singapore
  • Rastogi Saurabh
    Department of Cardiology, Ng Teng Fong General Hospital
  • Kojodjojo Pipin
    Department of Cardiology, National University Heart Centre, National University Health System Yong Loo Lin School of Medicine, National University of Singapore Department of Cardiology, Ng Teng Fong General Hospital
  • Chor Wei Ping Daniel
    Emergency Medicine Department, National University Hospital
  • Leong Benjamin Sieu-Hon
    Emergency Medicine Department, National University Hospital
  • Koh Brandon Chi-Ping
    Emergency Medicine Department, National University Hospital
  • Tam Howen
    Emergency Medicine Department, Ng Teng Fong General Hospital
  • Quek Lit-Sin
    Emergency Medicine Department, Ng Teng Fong General Hospital
  • Sia Winnie CH
    Department of Cardiology, National University Heart Centre, National University Health System
  • Saw Kalyar Win
    Department of Cardiology, National University Heart Centre, National University Health System
  • Tung Benjamin Wei-Liang
    Department of Cardiology, National University Heart Centre, National University Health System
  • Ng Zan Zhe-Yan
    Department of Cardiology, National University Heart Centre, National University Health System
  • Ambhore Anand
    Department of Cardiology, National University Heart Centre, National University Health System
  • Tay Edgar Lik-Wui
    Department of Cardiology, National University Heart Centre, National University Health System Yong Loo Lin School of Medicine, National University of Singapore
  • Chan Koo-Hui
    Department of Cardiology, National University Heart Centre, National University Health System
  • Lee Chi-Hang
    Department of Cardiology, National University Heart Centre, National University Health System Yong Loo Lin School of Medicine, National University of Singapore
  • Loh Joshua Ping-Yun
    Department of Cardiology, National University Heart Centre, National University Health System Yong Loo Lin School of Medicine, National University of Singapore
  • Low Adrian Fatt-Hoe
    Department of Cardiology, National University Heart Centre, National University Health System Yong Loo Lin School of Medicine, National University of Singapore
  • Chan Mark Yan-Yee
    Department of Cardiology, National University Heart Centre, National University Health System Yong Loo Lin School of Medicine, National University of Singapore
  • Yeo Tiong-Cheng
    Department of Cardiology, National University Heart Centre, National University Health System Yong Loo Lin School of Medicine, National University of Singapore
  • Tan Huay-Cheem
    Department of Cardiology, National University Heart Centre, National University Health System Yong Loo Lin School of Medicine, National University of Singapore
  • Loh Poay-Huan
    Department of Cardiology, National University Heart Centre, National University Health System Yong Loo Lin School of Medicine, National University of Singapore

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<p>Background:Little is known about the effect of the coronavirus disease 2019 (COVID-19) pandemic and the outbreak response measures on door-to-balloon time (D2B). This study examined both D2B and clinical outcomes of patients with STEMI undergoing primary percutaneous coronary intervention (PPCI).</p><p>Methods and Results:This was a retrospective study of 303 STEMI patients who presented directly or were transferred to a tertiary hospital in Singapore for PPCI from October 2019 to March 2020. We compared the clinical outcomes of patients admitted before (BOR) and during (DOR) the COVID-19 outbreak response. The study outcomes were in-hospital death, D2B, cardiogenic shock and 30-day readmission. For direct presentations, fewer patients in the DOR group achieved D2B time <90 min compared with the BOR group (71.4% vs. 80.9%, P=0.042). This was more apparent after exclusion of non-system delay cases (DOR 81.6% vs. BOR 95.9%, P=0.006). Prevalence of both out-of-hospital cardiac arrest (9.5% vs. 1.9%, P=0.003) and acute mitral regurgitation (31.6% vs. 17.5%, P=0.006) was higher in the DOR group. Mortality was similar between groups. Multivariable regression showed that longer D2B time was an independent predictor of death (odds ratio 1.005, 95% confidence interval 1.000–1.011, P=0.029).</p><p>Conclusions:The COVID-19 pandemic and the outbreak response have had an adverse effect on PPCI service efficiency. The study reinforces the need to focus efforts on shortening D2B time, while maintaining infection control measures.</p>

収録刊行物

  • Circulation Journal

    Circulation Journal 85 (2), 139-149, 2021-01-25

    一般社団法人 日本循環器学会

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