Gender Difference in the Effects of COVID-19 Pandemic on Mechanical Reperfusion and 30-Day Mortality for STEMI: Results of the ISACS-STEMI COVID-19 Registry.

Journal: Journal Of Clinical Medicine

Published: December 18, 2022

Abstract

Background: Several reports have demonstrated the impact of the COVID-19 pandemic on the management and outcome of patients with ST-segment elevation myocardial infarction (STEMI). The aim of the current analysis is to investigate the potential gender difference in the effects of the COVID-19 pandemic on mechanical reperfusion and 30-day mortality for STEMI patients within the ISACS-STEMI COVID-19 Registry.

Methods: This retrospective multicenter registry was performed in high-volume primary percutaneous coronary intervention (PPCI) centers on four continents and included STEMI patients undergoing PPCIs in March-June 2019 and 2020. Patients were divided according to gender. The main outcomes were the incidence and timing of the PPCI, (ischemia time ≥ 12 h and door-to-balloon ≥ 30 min) and in-hospital or 30-day mortality.

Results: We included 16683 STEMI patients undergoing PPCIs in 109 centers. In 2020 during the pandemic, there was a significant reduction in PPCIs compared to 2019 (IRR 0.843 (95% CI: 0.825-0.861, p < 0.0001). We did not find a significant gender difference in the effects of the COVID-19 pandemic on the numbers of STEMI patients, which were similarly reduced from 2019 to 2020 in both groups, or in the mortality rates. Compared to prepandemia, 30-day mortality was significantly higher during the pandemic period among female (12.1% vs. 8.7%; adjusted HR [95% CI] = 1.66 [1.31-2.11], p < 0.001) but not male patients (5.8% vs. 6.7%; adjusted HR [95% CI] = 1.14 [0.96-1.34], p = 0.12).

Conclusions: The COVID-19 pandemic had a significant impact on the treatment of patients with STEMI, with a 16% reduction in PPCI procedures similarly observed in both genders. Furthermore, we observed significantly increased in-hospital and 30-day mortality rates during the pandemic only among females. Trial registration number: NCT 04412655.

Authors

Giuseppe De Luca, Stephane Manzo Silberman, Magdy Algowhary, Berat Uguz, Dinaldo Oliveira, Vladimir Ganyukov, Oliver Busljetik, Miha Cercek, Lisette Okkels, Poay Loh, Lucian Calmac, Gerard Roura Ferrer, Alexandre Quadros, Marek Milewski, Fortunato Scotto Di Uccio, Clemens Von Birgelen, Francesco Versaci, Jurrien Ten Berg, Gianni Casella, Aaron Wong Sung Lung, Petr Kala, José Díez Gil, Xavier Carrillo, Maurits Dirksen, Victor Becerra, Michael Lee, Dafsah Juzar, Rodrigo De Moura Joaquim, Roberto Paladino, Davor Milicic, Periklis Davlouros, Nikola Bakraceski, Filippo Zilio, Luca Donazzan, Adriaan Kraaijeveld, Gennaro Galasso, Lux Arpad, Lucia Marinucci, Vincenzo Guiducci, Maurizio Menichelli, Alessandra Scoccia, Aylin Yamac, Kadir Ugur Mert, Xacobe Flores Rios, Tomas Kovarnik, Michal Kidawa, Josè Moreu, Vincent Flavien, Enrico Fabris, Iñigo Martínez Luengas, Marco Boccalatte, Francisco Ojeda, Carlos Arellano Serrano, Gianluca Caiazzo, Giuseppe Cirrincione, Hsien-li Kao, Juan Forés, Luigi Vignali, Helder Pereira, Santiago Ordoñez, Alev Arat Özkan, Bruno Scheller, Heidi Lehtola, Rui Teles, Christos Mantis, Ylitalo Antti, João Brum Silveira, Cesar Zoni, Ivan Bessonov, Giuseppe Uccello, George Kochiadakis, Dimitrios Alexopulos, Carlos Uribe, John Kanakakis, Benjamin Faurie, Gabriele Gabrielli, Alejandro Barrios, Juan Bachini, Alex Rocha, Frankie Tam, Alfredo Rodriguez, Antonia Lukito, Veauthyelau Saint Joy, Gustavo Pessah, Andrea Tuccillo, Alfonso Ielasi, Giuliana Cortese, Guido Parodi, Mohamed Bouraghda, Marcia Moura, Elvin Kedhi, Pablo Lamelas, Harry Suryapranata, Matteo Nardin, Monica Verdoia

Relevant Conditions

Percutaneous Coronary Intervention (PCI), Heart Attack, COVID-19

Gender Difference in the Effects of COVID-19 Pandemic on Mechanical Reperfusion and 30-Day Mortality for STEMI: Results of the ISACS-STEMI COVID-19 Registry.

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