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Impact of Coronavirus Disease 2019 outbreak on acute coronary syndrome admissions: four weeks to reverse the trend.

Identifieur interne : 000365 ( Main/Exploration ); précédent : 000364; suivant : 000366

Impact of Coronavirus Disease 2019 outbreak on acute coronary syndrome admissions: four weeks to reverse the trend.

Auteurs : Marie Hauguel-Moreau [France] ; Rémy Pillière [France] ; Giulio Prati [France] ; Sébastien Beaune [France] ; Thomas Loeb [France] ; Simon Lannou [France] ; Sophie Mallet [France] ; Hazrije Mustafic [France] ; Céline Bégué [France] ; Olivier Dubourg [France] ; Nicolas Mansencal [France]

Source :

RBID : pubmed:32601849

Abstract

Data whether the COVID-19 outbreak impacts the acute coronary syndromes (ACS) admissions and the time required to reverse the downward curve are scarce. We included all consecutive patients referred for an ACS who underwent PCI from February 17, 2020 to April 26, 2020 in a high-volume PCI coronary care unit. We compared the number of ACS patients in 2020 to the same period in 2018 and 2019. Predictors of adverse outcome in ST-elevation myocardial infarction (STEMI) patients were recorded: symptom-onset-to-first medical contact (FMC), and FMC-to-sheath insertion times. During the studied period (calendar weeks 8-17, 2018-2020), 144 ACS patients were included. In 2020, we observed two distinct phases in the ACS admissions: a first significant fall, with a relative reduction of 73%, from the week of lockdown (week 12) to 3 weeks later and then an increase of ACS. Median symptom-onset-to-FMC time was significantly higher in 2020 than in the two previous years (600 min [298-632] versus 121 min [55-291], p < 0.001). Median FMC-to-sheath insertion did not differ significantly (93 min [81-131] in 2020 versus 90 min [67-137] in 2018-2019, p = 0.57). The main findings are (1) a pattern of a U-curve in ACS admissions, with a first decrease in ACS admissions and a return to "normality" 4 weeks after; (2) a significant increase in the total ischemic time exclusively due to an increase in the symptom-onset-to-first-medical-contact time.

DOI: 10.1007/s11239-020-02201-9
PubMed: 32601849
PubMed Central: PMC7323878


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<div type="abstract" xml:lang="en">Data whether the COVID-19 outbreak impacts the acute coronary syndromes (ACS) admissions and the time required to reverse the downward curve are scarce. We included all consecutive patients referred for an ACS who underwent PCI from February 17, 2020 to April 26, 2020 in a high-volume PCI coronary care unit. We compared the number of ACS patients in 2020 to the same period in 2018 and 2019. Predictors of adverse outcome in ST-elevation myocardial infarction (STEMI) patients were recorded: symptom-onset-to-first medical contact (FMC), and FMC-to-sheath insertion times. During the studied period (calendar weeks 8-17, 2018-2020), 144 ACS patients were included. In 2020, we observed two distinct phases in the ACS admissions: a first significant fall, with a relative reduction of 73%, from the week of lockdown (week 12) to 3 weeks later and then an increase of ACS. Median symptom-onset-to-FMC time was significantly higher in 2020 than in the two previous years (600 min [298-632] versus 121 min [55-291], p < 0.001). Median FMC-to-sheath insertion did not differ significantly (93 min [81-131] in 2020 versus 90 min [67-137] in 2018-2019, p = 0.57). The main findings are (1) a pattern of a U-curve in ACS admissions, with a first decrease in ACS admissions and a return to "normality" 4 weeks after; (2) a significant increase in the total ischemic time exclusively due to an increase in the symptom-onset-to-first-medical-contact time.</div>
</front>
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<MedlineCitation Status="In-Process" Owner="NLM">
<PMID Version="1">32601849</PMID>
<DateRevised>
<Year>2021</Year>
<Month>01</Month>
<Day>25</Day>
</DateRevised>
<Article PubModel="Print">
<Journal>
<ISSN IssnType="Electronic">1573-742X</ISSN>
<JournalIssue CitedMedium="Internet">
<Volume>51</Volume>
<Issue>1</Issue>
<PubDate>
<Year>2021</Year>
<Month>Jan</Month>
</PubDate>
</JournalIssue>
<Title>Journal of thrombosis and thrombolysis</Title>
<ISOAbbreviation>J Thromb Thrombolysis</ISOAbbreviation>
</Journal>
<ArticleTitle>Impact of Coronavirus Disease 2019 outbreak on acute coronary syndrome admissions: four weeks to reverse the trend.</ArticleTitle>
<Pagination>
<MedlinePgn>31-32</MedlinePgn>
</Pagination>
<ELocationID EIdType="doi" ValidYN="Y">10.1007/s11239-020-02201-9</ELocationID>
<Abstract>
<AbstractText>Data whether the COVID-19 outbreak impacts the acute coronary syndromes (ACS) admissions and the time required to reverse the downward curve are scarce. We included all consecutive patients referred for an ACS who underwent PCI from February 17, 2020 to April 26, 2020 in a high-volume PCI coronary care unit. We compared the number of ACS patients in 2020 to the same period in 2018 and 2019. Predictors of adverse outcome in ST-elevation myocardial infarction (STEMI) patients were recorded: symptom-onset-to-first medical contact (FMC), and FMC-to-sheath insertion times. During the studied period (calendar weeks 8-17, 2018-2020), 144 ACS patients were included. In 2020, we observed two distinct phases in the ACS admissions: a first significant fall, with a relative reduction of 73%, from the week of lockdown (week 12) to 3 weeks later and then an increase of ACS. Median symptom-onset-to-FMC time was significantly higher in 2020 than in the two previous years (600 min [298-632] versus 121 min [55-291], p < 0.001). Median FMC-to-sheath insertion did not differ significantly (93 min [81-131] in 2020 versus 90 min [67-137] in 2018-2019, p = 0.57). The main findings are (1) a pattern of a U-curve in ACS admissions, with a first decrease in ACS admissions and a return to "normality" 4 weeks after; (2) a significant increase in the total ischemic time exclusively due to an increase in the symptom-onset-to-first-medical-contact time.</AbstractText>
</Abstract>
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<Author ValidYN="Y">
<LastName>Hauguel-Moreau</LastName>
<ForeName>Marie</ForeName>
<Initials>M</Initials>
<Identifier Source="ORCID">http://orcid.org/0000-0002-9804-1868</Identifier>
<AffiliationInfo>
<Affiliation>Department of Cardiology, Ambroise Paré Hospital (AP-HP), ACTION Study Group, Université de Versailles-Saint Quentin, Boulogne, France. marie.hauguel@aphp.fr.</Affiliation>
</AffiliationInfo>
<AffiliationInfo>
<Affiliation>INSERM U-1018, CESP, Épidémiologie clinique, Villejuif, France. marie.hauguel@aphp.fr.</Affiliation>
</AffiliationInfo>
</Author>
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<LastName>Pillière</LastName>
<ForeName>Rémy</ForeName>
<Initials>R</Initials>
<AffiliationInfo>
<Affiliation>Department of Cardiology, Ambroise Paré Hospital (AP-HP), ACTION Study Group, Université de Versailles-Saint Quentin, Boulogne, France.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Prati</LastName>
<ForeName>Giulio</ForeName>
<Initials>G</Initials>
<AffiliationInfo>
<Affiliation>Department of Cardiology, Ambroise Paré Hospital (AP-HP), ACTION Study Group, Université de Versailles-Saint Quentin, Boulogne, France.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Beaune</LastName>
<ForeName>Sébastien</ForeName>
<Initials>S</Initials>
<AffiliationInfo>
<Affiliation>Department of Emergency Medicine, Ambroise Paré Hospital, AP-HP, Boulogne-Billancourt, France.</Affiliation>
</AffiliationInfo>
</Author>
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<LastName>Loeb</LastName>
<ForeName>Thomas</ForeName>
<Initials>T</Initials>
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<Affiliation>Service D'Aide Médicale D'Urgence (SAMU), Raymond Poincaré Hospital, APHP, Garches, France.</Affiliation>
</AffiliationInfo>
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<LastName>Lannou</LastName>
<ForeName>Simon</ForeName>
<Initials>S</Initials>
<AffiliationInfo>
<Affiliation>Department of Cardiology, Ambroise Paré Hospital (AP-HP), ACTION Study Group, Université de Versailles-Saint Quentin, Boulogne, France.</Affiliation>
</AffiliationInfo>
<AffiliationInfo>
<Affiliation>INSERM U-1018, CESP, Épidémiologie clinique, Villejuif, France.</Affiliation>
</AffiliationInfo>
</Author>
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<LastName>Mallet</LastName>
<ForeName>Sophie</ForeName>
<Initials>S</Initials>
<AffiliationInfo>
<Affiliation>Department of Cardiology, Ambroise Paré Hospital (AP-HP), ACTION Study Group, Université de Versailles-Saint Quentin, Boulogne, France.</Affiliation>
</AffiliationInfo>
<AffiliationInfo>
<Affiliation>INSERM U-1018, CESP, Épidémiologie clinique, Villejuif, France.</Affiliation>
</AffiliationInfo>
</Author>
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<LastName>Mustafic</LastName>
<ForeName>Hazrije</ForeName>
<Initials>H</Initials>
<AffiliationInfo>
<Affiliation>Department of Cardiology, Ambroise Paré Hospital (AP-HP), ACTION Study Group, Université de Versailles-Saint Quentin, Boulogne, France.</Affiliation>
</AffiliationInfo>
<AffiliationInfo>
<Affiliation>INSERM U-1018, CESP, Épidémiologie clinique, Villejuif, France.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Bégué</LastName>
<ForeName>Céline</ForeName>
<Initials>C</Initials>
<AffiliationInfo>
<Affiliation>Department of Cardiology, Ambroise Paré Hospital (AP-HP), ACTION Study Group, Université de Versailles-Saint Quentin, Boulogne, France.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Dubourg</LastName>
<ForeName>Olivier</ForeName>
<Initials>O</Initials>
<AffiliationInfo>
<Affiliation>Department of Cardiology, Ambroise Paré Hospital (AP-HP), ACTION Study Group, Université de Versailles-Saint Quentin, Boulogne, France.</Affiliation>
</AffiliationInfo>
<AffiliationInfo>
<Affiliation>INSERM U-1018, CESP, Épidémiologie clinique, Villejuif, France.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Mansencal</LastName>
<ForeName>Nicolas</ForeName>
<Initials>N</Initials>
<AffiliationInfo>
<Affiliation>Department of Cardiology, Ambroise Paré Hospital (AP-HP), ACTION Study Group, Université de Versailles-Saint Quentin, Boulogne, France.</Affiliation>
</AffiliationInfo>
<AffiliationInfo>
<Affiliation>INSERM U-1018, CESP, Épidémiologie clinique, Villejuif, France.</Affiliation>
</AffiliationInfo>
</Author>
</AuthorList>
<Language>eng</Language>
<PublicationTypeList>
<PublicationType UI="D016428">Journal Article</PublicationType>
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<Country>Netherlands</Country>
<MedlineTA>J Thromb Thrombolysis</MedlineTA>
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<ISSNLinking>0929-5305</ISSNLinking>
</MedlineJournalInfo>
<CitationSubset>IM</CitationSubset>
<KeywordList Owner="NOTNLM">
<Keyword MajorTopicYN="N">Acute coronary syndrome</Keyword>
<Keyword MajorTopicYN="N">COVID-19</Keyword>
<Keyword MajorTopicYN="N">ST-elevation myocardial infarction</Keyword>
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<Month>7</Month>
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<Reference>
<Citation>Metzler B, Siostrzonek P, Binder RK, Bauer A, Reinstadler SJ (2020) Decline of acute coronary syndrome admissions in Austria since the outbreak of COVID-19: the pandemic response causes cardiac collateral damage. Eur Heart J 41:1852–1853</Citation>
<ArticleIdList>
<ArticleId IdType="doi">10.1093/eurheartj/ehaa314</ArticleId>
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<Reference>
<Citation>Garcia S, Albaghdadi MS, Meraj PM, Schmidt C, Garberich R, Jaffer FA, Dixon S, Rade JJ, Tannenbaum M, Chambers J et al (2020) Reduction in ST-segment elevation cardiac catheterization laboratory activations in the United States during COVID-19 pandemic. J Am Coll Cardiol 75:2871–2872</Citation>
<ArticleIdList>
<ArticleId IdType="doi">10.1016/j.jacc.2020.04.011</ArticleId>
</ArticleIdList>
</Reference>
<Reference>
<Citation>Tam CF, Cheung KS, Lam S, Wong A, Yung A, Sze M, Lam YM, Chan C, Tsang TC, Tsui M et al (2020) Impact of Coronavirus Disease 2019 (COVID-19) outbreak on ST-segment–elevation myocardial infarction care in Hong Kong, China. Circ Cardiovasc Qual Outcomes 13(4):e006631. https://doi.org/10.1161/CIRCOUTCOMES.120.006631</Citation>
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<ArticleId IdType="doi">10.1161/CIRCOUTCOMES.120.006631</ArticleId>
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<li>France</li>
</country>
<region>
<li>Île-de-France</li>
</region>
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<li>Boulogne-Billancourt</li>
<li>Villejuif</li>
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<name sortKey="Begue, Celine" sort="Begue, Celine" uniqKey="Begue C" first="Céline" last="Bégué">Céline Bégué</name>
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<name sortKey="Hauguel Moreau, Marie" sort="Hauguel Moreau, Marie" uniqKey="Hauguel Moreau M" first="Marie" last="Hauguel-Moreau">Marie Hauguel-Moreau</name>
<name sortKey="Lannou, Simon" sort="Lannou, Simon" uniqKey="Lannou S" first="Simon" last="Lannou">Simon Lannou</name>
<name sortKey="Lannou, Simon" sort="Lannou, Simon" uniqKey="Lannou S" first="Simon" last="Lannou">Simon Lannou</name>
<name sortKey="Loeb, Thomas" sort="Loeb, Thomas" uniqKey="Loeb T" first="Thomas" last="Loeb">Thomas Loeb</name>
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<name sortKey="Mustafic, Hazrije" sort="Mustafic, Hazrije" uniqKey="Mustafic H" first="Hazrije" last="Mustafic">Hazrije Mustafic</name>
<name sortKey="Mustafic, Hazrije" sort="Mustafic, Hazrije" uniqKey="Mustafic H" first="Hazrije" last="Mustafic">Hazrije Mustafic</name>
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<name sortKey="Prati, Giulio" sort="Prati, Giulio" uniqKey="Prati G" first="Giulio" last="Prati">Giulio Prati</name>
</country>
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</record>

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