Reorganizing as a Covid-Free Heart Center: Does It Really Matter For The Primary Percutaneous Coronary Intervention Endpoints During the Covid-19 Pandemic?

Authors : Serhan ÖZYILDIRIM

Pages : 209-214

Doi:10.16899/jcm.1225987

View : 9 | Download : 6

Publication Date : 2023-03-22

Article Type : Research Paper

Abstract :Backrounds/Aims: With the emergence of the new and more transmissible COVID variants such as Omicron, the necessity of taking new measures began to be discussed. Methods: Data regarding the organizational arrangements as defining COVID-free heart centers during the first waves is scarce. We evaluated the 273 non-COVID acute coronary syndrome patients who were admitted to our COVID-free tertiary cardiovascular center during the lockdown period. None of these cases had hospital acquired SARS CoV-2 infection during the follow-up. Therefore, no COVID-related morbidity or mortality was observed in this vulnerable group. Results: However, when we analyzed the 88 primary percutaneous coronary intervention procedures of the non-COVID STEMI patients of the lockdown period and compared the 70 of them with the 50 STEMI patients of the previous year, the results were not that encouraging. Even our hospital was declared as a COVID-free cardiolovascular center, there was a significant delay in the symptom-to-door time insert ignore into journalissuearticles values(SDT); during the pandemic insert ignore into journalissuearticles values(4.8 vs. 2.5 hours, respectively; P<0.001);. Door-to-balloon time insert ignore into journalissuearticles values(DBT); for the lockdown period was not different than the prepandemic era. The main difference regarding the angiographic endpoints was in corrected TIMI frame counts insert ignore into journalissuearticles values(cTFC); which was significantly higher during the pandemic insert ignore into journalissuearticles values(32.9 vs. 27.3); insert ignore into journalissuearticles values(P<0.001);. Furthermore, a powerful positive correlation between SDT and TFC was represented insert ignore into journalissuearticles values(R=0.731, p<0.001);. Hospitalization duration was shortened during the pandemic insert ignore into journalissuearticles values(2.3 days in pandemic and 3.4 days in 2019, P<0.001);. None of the patients had hospital-acquired infection and related morbidity. However, in-hospital mortality was significantly higher than the previous year’s insert ignore into journalissuearticles values(11.4% vs. 1.8% respectively, P=0.039);. TFC was found to be an independent predictor of in-hospital cardiac events insert ignore into journalissuearticles values(OR: 1.17, 95% CI: 1.05-1.31, P< 0.01);. Conclusions: These results suggest that, when we exclude morbidity and mortality resulting from hospital-acquired infection, reorganizing as a COVID-free cardiac center doesn’t have satisfactory favorable impact on the adverse cardiovascular outcome during the pandemic, unless the public is well informed.
Keywords : STEMI, COVID 19, perkütan koroner girişim