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

Journal Pre-Proof

Key Points:

  • Data gathered from 9 US centers with greater than 100 PCIs per year
  • March 1, 2020 defined as date of onset of “After COVID” (AC) Before March 1, considered “Before COVID” (BC)
  • The “control” BC time frame was January 1, 2020 – February 29, 2020 -14 months
  • There is a 38% (95% CI: 26-49; p<0.001) reduction in Cath Lab STEMI activation since the onset of COVID – 19
  • Total Site monthly activation for all centers BC was > 180 per month (Av. 23.6 activations/month); AC Site activation was 138 (mean 15.3 per month)
  • Reduction in US STEMI activation parallels the reduction of 40% in Spain (Rodríguez-Leor O, et al. REC Interv Cardiol. 2020) posted separately on this A-Cure site
  • The authors note that with given social stress, an influenza-like illness and potential “false-positives”, one would have expected an increase in activations.
  • Potential causes for a decline (despite ACC/SCAI recommendation to continue primary PCI as standard STEMI management despite the Pandemic) include:
  • avoidance of contacting Medical Systems 2nd to concerns of COVID -19 exposure in a hospital
  • Misdiagnosis of STEMI
  • Pharmacological reperfusion to protect medical staff from COVID-19 infection possible related to limited PPE.
  • Close monitoring and reevaluations of treatment strategies including supporting guideline recommendations will be critical going forward to insure that STEMI patients receive appropriate management.