Early outcome of on- versus off-hours admission in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI) during COVID-19 pandemic

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Background Most of studies have found no relevant impact of admission time on STEMI outcome among patients treated with primary PCI. Whether this observation has been affected by coronavirus disease (COVID-19) pandemic, in particular during the curfew application, has not been evaluated. Purpose To study the influence of admission time on the outcome of STEMI patients treated with primary PCI during COVID-19 pandemic in a large volume University Hospital Center, the only center capable of primary PCI serving a large area without an established STEMI network Methods Characteristics and outcomes of 308 consecutive STEMI patients admitted to our center between May 28 to December 2020, were collected. On-hours were defined as admission from Monday through Friday from 8:00 to 15:30 and off-hours admission from 15:30 to 8:00, weekends and non-working holidays. Clinical characteristics, key time delays and in-hospital and 3-month mortality were evaluated. Results 75 (24%) patients were admitted on-hours and 233 (76%) patients were admitted off-hours. There were no differences between groups regarding baseline clinical characteristics, laboratory data and STEMI clinical presentation. Median time from pain onset to coronary care unit admission was 4.0 hours in the on-hours group versus 6.0 hours in the off-hours group (p=0.11). Median time from coronary care unit to cathlab was 1.5 hours in the on-hours group versus 1.0 hour in the off-hour group (p=0.14). There was no difference between on-hours versus off- groups regarding in-hospital mortality (4% versus 6%, p=0.77) and 3-month mortality (10% versus 10%, p=0.76), as well as recurrent infarction (p=0.56) and stent thrombosis (p=0.64). Conclusion(s) Despite the lack of an organized STEMI network, patients admitted to a large-volume primary PCI tertiary center during COVID-19 pandemic, had similar outcome regardless their admission during on-hours or off-hours. Althgouh the specific impact of curfew on out of hospital time delays could not be assessed, it did not appear to influence patient outcomes.