key: cord-0809356-ejsoy2bj
authors: Piccolo, Raffaele; Esposito, Giovanni
title: Percutaneous coronary intervention in patients with COVID‐19 and acute coronary syndrome: What if the old normal became the new normal?
date: 2021-02-15
journal: Catheter Cardiovasc Interv
DOI: 10.1002/ccd.29480
sha: 8def41482f546fbdb73e753c28a3cb278e1fe24c
doc_id: 809356
cord_uid: ejsoy2bj

The management of COVID‐19 patients with acute coronary syndrome (ACS) remains challenging. This initial experience supports the safety and efficacy of invasive assessment in patients with COVID‐19 and ACS as well as the safety of the procedure for healthcare personnel. The study findings raise the question of whether we should continue to follow “COVID‐19 guidelines” suggesting a more conservative approach to ACS patients with COVID‐19 or rather go back to a more unrestricted use of invasive angiography and revascularization.

• The study findings raise the question of whether we should continue to follow "COVID-19 guidelines" suggesting a more conservative approach to ACS patients with COVID-19 or rather go back to a more We know that fibrinolysis is inferior to primary PCI in terms of safety and efficacy and that a conservative management in patients with non-ST-elevation ACS is inferior to a routine invasive strategy in terms of reinfarction and refractory angina. Consequently, as long as invasive assessment can be safely and timely performed, 4 we should go back to the "normal" guidelines supporting primary PCI and early invasive strategy for the majority of patients with ST-elevation and non-ST-elevation ACS, respectively. Data suggest that patients with concomitant coronary artery disease and COVID-19 have a threefold higher risk of mortality, 5 which is mainly explained by the burden of comorbidities. Hence, invasive angiography with the possibility of revascularization not only should not be withheld in COVID-19 patients with ACS, but rather supported as the authors brilliantly did.

Recent preliminary data from the US Centers for Disease Control and Prevention indicate that COVID-19 was likely the third leading cause of death in the United States in 2020. Confirmed or not, cardiovascular diseases will remain the number 1 cause of death. As such, we should commit to deliver the most safe and effective therapies to patients with ACS irrespective of their COVID-19 status.

https://orcid.org/0000-0003-0565-7127

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Percutaneous coronary intervention in patients with COVID-19 and acute coronary syndrome: What if the old normal became the new normal?