key: cord-0768705-c4c1i60w
authors: Moreno, Raúl; Alonso, Joaquín J.; Caballero, Rafael; del Corral, Ervigio; Elízaga, Jaime; Asenjo, Roberto Martin; Mena, Manuel Jiménez; Alfonso, Fernando; Fernández-Ortiz, Antonio; Goicolea, Francisco Javier; Botas, Javier; Navarro, Felipe; Alegría-Barrero, Eduardo; Ansede, Juan Carlos; de Sá, Esteban López; López-Sendón, José Luis
title: Influence of age and gender on arrival of patients with ST-segment elevation acute myocardial infarction to tertiary centers during COVID-19 pandemic. Experience of Madrid, Spain, STEMI network (Codigo Infarto Madrid)
date: 2020-06-06
journal: Am J Emerg Med
DOI: 10.1016/j.ajem.2020.06.013
sha: 2eacb6bb4f5f45e76558fefad759d93766968e05
doc_id: 768705
cord_uid: c4c1i60w

nan

This has led to more restrictive indications for invasive procedures and to defer elective procedures 1 , contributing to a reduction on the activity at catheterization laboratories.

More striking is the ≈40% reduction in the number of patients with STsegment elevation myocardial infarction (STEMI) 2,3 . This is surprising because the incidence of cardiovascular events usually increases with respiratory infections 4 . Potential explanations may include reluctance of patients for seeking medical assistance due to the possibility of SARS-CoV-2 contamination, attribution of symptoms to COVID-19 infection, health system failures and diagnostic errors in attending patients with chest pain, delay in diagnosis losing the benefit of early coronary reperfusion, increased use of thrombolysis, and cardiac death before medical attendance.

Among patients with STEMI, women and elderly are associated with longer delay of accessing medical care 5 , and reduction of STEMI patients during COVID-19 pandemic could affect mainly to women and older patients.

In the region of Madrid (Spain, 6.7 million inhabitants), which STEMI care is organized in a network including 11 hospitals with percutaneous coronary intervention facilities 24 hours a day, 365 days per year. During COVID-19 pandemic, reperfusion protocols were not changed, and all except one (whose activity was absorbed by the closest hospitals) STEMI centers maintained their capability to attend patients with STEMI. 

Considerations on the invasive management of ischemic and structural heart disease during the COVID-19 coronavirus outbreak. Consensus statement of the Interventional Cardiology Association and the Ischemic Heart Disease and Acute Cardiac Care Association of the Spanish Society of Cardiology. REC: Interventional Cardiology 2020. Ahead-of-print

Impact of COVID-19 pandemic over activity of interventional cardiology in Spain. REC: Interventional Cardiology

Reduction in ST-Segment Elevation Cardiac Catheterization Laboratory Activations in the United States during COVID-19 Pandemic

Acute Infection and Myocardial Infarction

Age and sex differences in duration of prehospital delay in patients with acute myocardial infarction: a systematic review