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ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Coronary Artery Disease
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1522661
The impact of the COVID-19 pandemic on ST-segment elevation myocardial infarction treatment strategy and outcomes
Provisionally accepted- 1st Department of Cardiology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Pomeranian, Poland
Background: The most reliable care quality indicators for STEMI patients undergoing primary percutaneous coronary intervention (pPCI) include onset-to-door time (OTDT), time from admission to wire crossing and in-hospital mortality. Aims: Our study aimed to evaluate the impact of the COVID-19 pandemic on these selected care quality indicators in pre-pandemic and pandemic groups of STEMI patients.Methods: This single-centre, retrospective study, enrolled 480 STEMI patients, aged 63.59±12.44 years treated with pPCI across two time frames: pre-pandemic (n=331) and pandemic (n=149). The evaluation criteria included OTDT, time from admission to PCI-mediated reperfusion, in-hospital mortality, and predictors of time delays.Results: Our study revealed a significant increases in OTDT (median 3 hours; IQR 1.5–12.0 vs median 5 hours; IQR 2.0–24.0, p=0.011) and time from admission to wire crossing (median 92 minutes; IQR 65.0–187.0 vs median 115.0; IQR 73.0–233.0, p=0.025), in the COVID-19 pandemic group of STEMI patients, compared to the pre-pandemic subset. We also observed an increase in in-hospital mortality (7.85% vs 14.09%, p=0.033) and incidence of cardiogenic shock/cardiac arrest (16.62% vs 26.85%, p=0.009). Additionally, the proportion of patients with prolonged OTDT (24.45% vs 35.71%, p=0.019) and extended time from admission to PCI-mediated reperfusion (51.96% vs 65.77%, p=0.005) increased during the pandemic period.Conclusions: The study's results indicated prolonged OTDT and admission-to-wire crossing times, increased in-hospital mortality, and the higher frequency of cardiogenic shock/cardiac arrest during the COVID-19 pandemic. These findings demonstrate the negative impact of the pandemic on treatment times and outcomes for patients diagnosed with STEMI.
Keywords: COVID-19 pandemic, OTDT, STEMI, time from admission to wire crossing, quality of care Angielski (amerykański)
Received: 04 Nov 2024; Accepted: 26 Mar 2025.
Copyright: © 2025 Bychowski, Michalski, Sobiczewski, Jaguszewski and Gruchała. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Jakub Bychowski, 1st Department of Cardiology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, 80-214, Pomeranian, Poland
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