key: cord-0693618-po4hz291
authors: Garcia, Santiago; Albaghdadi, Mazen S.; Meraj, Perwaiz M.; Schmidt, Christian; Garberich, Ross; Jaffer, Farouc A.; Dixon, Simon; Rade, Jeffrey J.; Tannenbaum, Mark; Chambers, Jenny; Huang, Paul P.; Henry, Timothy D.
title: Reduction in ST-Segment Elevation Cardiac Catheterization Laboratory Activations in the United States during COVID-19 Pandemic
date: 2020-04-10
journal: J Am Coll Cardiol
DOI: 10.1016/j.jacc.2020.04.011
sha: 4296fdc0cb75fc48e24d30ad897b96f254ddbdbc
doc_id: 693618
cord_uid: po4hz291

nan

The COVID-19 Pandemic has significantly impacted the US healthcare system. To preserve resources, including personal protective equipment (PPE) and hospital beds to care for COVID-19 patients, the Centers for Disease Control and Prevention (CDC) recommended deferral of elective cardiac procedures (1), including coronary angiography and percutaneous coronary intervention for stable coronary artery disease.

Timely reperfusion by means of primary percutaneous coronary intervention (PPCI) is the standard of care for STEMI patients (2) . The Society for Cardiac Angiography and Interventions (SCAI) and American College of Cardiology (ACC) continue to recommend PPCI as the standard treatment of STEMI patients during the current pandemic (3). However, anecdotal reports suggest a decline in PPCI volumes in the US and around the world (4).

To determine if a decrease in PPCI is occurring in the US in the COVID-19 era, we Our preliminary analysis during the early phase of the COVID pandemic shows an estimated 38% reduction in US cardiac catheterization laboratory STEMI activations, similar to the 40% reduction noticed in Spain (4) . A priori, given potential heightened environmental and psychosocial stressors, and a higher case of STEMI induced by viral illness (e.g. similar to influenza) (5) or mimickers such as COVID-19 myopericarditis an increase in STEMI activations would have been expected. Potential etiologies for the decrease in STEMI PPCI activations include avoidance of medical care due to social distancing or concerns of contracting COVID-19 in the hospital, STEMI misdiagnosis, and increased use of pharmacological reperfusion due to COVID-19. As the pandemic continues, we plan to continue to follow this early signal and investigate its causes. It is particularly crucial to understand if patient-based anxiety is decreasing presentation of STEMI patients to the US hospital system. 

?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019

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Acute Myocardial Infarction after Laboratory-Confirmed Influenza Infection