Abstract:

Objective To analyze the effectiveness and safety of optimized treatment approach for acute ST-segment elevation myocardial infarction(STEMI) patients under the situation of prevention and control of COVID-19.Methods Consecutive 34 acute STEMI patients admitted to the Department of Cardiology of the Second Hospital of Hebei Medical University under COVID-19 prevention and control were included in study group, and 62 acute STEMI patients admitted during COVID-19 prevention and control period were included in control group. The general clinical data, reperfusion treatment status (time from system onset to first medical contact,onset-to-FMC), time from first medical contact to wire(FMC-to-W), thrombolysis in myocardial infarction(TIMI) blood flow classification, total ischemic time (time from symptom onset to guide wire passing through the lesion), the time from the first medical contact to the start of thrombolysis (FMC to needle of thrombolysis, FMC-to-N), thrombolysis recanalization rate, the rate of reperfusion therapy within 24 hours, stent implantation rate, hospitalization time, etc), major adverse cardiac events(MACEs) were recorded.Results Compared with the control group, Onset-to-FMC time and total ischemic time in the study group were significantly prolonged (P<0.05), and the proportion of receiving intravenous thrombolytic therapy was significantly increased, while the proportion of undergoing direct percutaneous coronary intervention(PCI) was significantly decreased(P<0.05), and the proportion of stent implantation and the hospitalization time were significantly decreased (P<0.05). The cardiac function indexes, the serum BNP at admission in the study group were significantly increased (P=0.042).Conclusion Under the situation of prevention and control of COVID-19, Onset-to-FMC time and total ischemic time of STEMI patients were significantly prolonged, the proportion of receiving intravenous thrombolytic therapy increased, while the proportion of receiving direct PCI decreased, but bleeding risk and MACEs have no increase. The study suggested that the optimized treatment approach ensures the effective reperfusion for STEMI patients, without adversely affecting the effectiveness and safety for the treatment of STEMI patients.

Key words: pneumonia,viral, coronavirus infections, ST elevation myocardial infarction, percutaneous coronary intervention, fibrinolytic agents, myocardial reperfusion