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Primary PCI in a regional centre – pandemic impact
Session:
Sessão de Posters 35 - Enfarte agudo do miocárdio com supra ST
Speaker:
Rafael Viana
Congress:
CPC 2024
Topic:
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme:
13. Acute Coronary Syndromes
Subtheme:
13.4 Acute Coronary Syndromes – Treatment
Session Type:
Cartazes
FP Number:
---
Authors:
Rafael Viana; Marta Figueiredo; Miguel Carias; António Almeida; Francisco Claúdio; Rita Rocha; Gustavo Mendes; Diogo Brás; David Neves; Ângela Bento; Renato Fernandes; Lino Patrício
Abstract
<p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Ischemic heart disease stands as the predominant cause of mortality. The mortality rate among individuals experiencing an acute coronary syndrome with ST-elevation (STEMI) is influenced by various factors, including the time lapse before treatment, encompassing percutaneous primary angioplasty (PPCI) or fibrinolysis. To enhance the quality of care, it is essential to systematically document and assess treatment delays. The COVID-19 pandemic had a profound impact on healthcare systems worldwide.</span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">We aim to analyse the impact of SARS-CoV-2 pandemic in times and delays in the emergent coronary referral pathway in our region. </span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">METHODS and RESULTS: We studied consecutive STEMI patients from 2013 to 2022, admitted in our centre for primary percutaneous coronary angioplasty (PPCI). We defined pandemic period as the interval between 2020 and 2022. Time variables included were: patient delay, electrocardiogram (ECG) delay, diagnostic delay, logistic delay, transport delay, home delay, procedure time. With these variables we also registered: first medical contact (FMC) to diagnosis time, door-in-door out time, door to wire, diagnosis to wire, FMC to wire and total ischemia time.</span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#374151">We included a total of 1962 PCI cases, with a median patient age of </span><span style="color:#374151">64 ± 14 years and with 74% being males. </span><span style="color:#374151">We found that median patient delay was higher during the SARS-CoV-2 pandemic (90min vs 105min, p=0,002) and that the median transport time during the same period was also higher (55min vs 62min, p<0,001). Home delay was lower during the pandemic interval (18min vs 12min, p<0,001). In contrast, procedure time was higher in SARS-CoV-2 period (27min vs 32min, p<0,001) and we verified the same considering total ischemia time (304min vs 326min,p<0,001).</span></span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#374151">CONCLUSION: The COVID-19 pandemic had a profound impact on healthcare systems worldwide and our centre was not an exception. As expected, patient delay was higher during the pandemic period reflecting the fear of looking for health care during this time. Importantly, our analysis show that the home delay was lower during pandemic, so we must maintain and improve the strategies adopted as a new foundation, so we can provide the best quality of care possible to our population.</span></span></span></p>
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