Please use this identifier to cite or link to this item: https://doi.org/10.1253/circj.CJ-20-0800
Title: Impact of the COVID-19 Pandemic on Door-to-Balloon Time for Primary Percutaneous Coronary Intervention - Results From the Singapore Western STEMI Network -
Authors: Chew, Nicholas WS
Sia, Ching-Hui 
Wee, Hwee-Lin 
Jia-Da Benedict, Loh
Rastogi, Saurabh
Kojodjojo, Pipin 
Chor, Wei Ping Daniel
Leong, Benjamin Sieu-Hon
Koh, Brandon Chi-Ping
Tam, Howen
Quek, Lit-Sin
Sia, Winnie CH
Saw, Kalyar Win
Tung, Benjamin Wei-Liang
Ng, Zan Zhe-Yan
Ambhore, Anand 
Tay, Edgar Lik-Wui
Chan, Koo-Hui 
Lee, Chi-Hang 
Loh, Joshua Ping-Yun
Low, Adrian Fatt-Hoe 
Chan, Mark Yan-Yee 
Yeo, Tiong-Cheng 
Tan, Huay-Cheem 
Loh, Poay-Huan 
Keywords: Coronavirus disease 2019 (COVID-19)
Primary percutaneous coronary intervention
ST-elevation myocardial infarction
Issue Date: 1-Feb-2021
Publisher: JAPANESE CIRCULATION SOC
Citation: Chew, Nicholas WS, Sia, Ching-Hui, Wee, Hwee-Lin, Jia-Da Benedict, Loh, Rastogi, Saurabh, Kojodjojo, Pipin, Chor, Wei Ping Daniel, Leong, Benjamin Sieu-Hon, Koh, Brandon Chi-Ping, Tam, Howen, Quek, Lit-Sin, Sia, Winnie CH, Saw, Kalyar Win, Tung, Benjamin Wei-Liang, Ng, Zan Zhe-Yan, Ambhore, Anand, Tay, Edgar Lik-Wui, Chan, Koo-Hui, Lee, Chi-Hang, Loh, Joshua Ping-Yun, Low, Adrian Fatt-Hoe, Chan, Mark Yan-Yee, Yeo, Tiong-Cheng, Tan, Huay-Cheem, Loh, Poay-Huan (2021-02-01). Impact of the COVID-19 Pandemic on Door-to-Balloon Time for Primary Percutaneous Coronary Intervention - Results From the Singapore Western STEMI Network -. CIRCULATION JOURNAL 85 (2) : 139-149. ScholarBank@NUS Repository. https://doi.org/10.1253/circj.CJ-20-0800
Abstract: Background: Little is known about the effect of the coronavirus disease 2019 (COVID-19) pandemic and the outbreak response measures on door-to-balloon time (D2B). This study examined both D2B and clinical outcomes of patients with STEMI undergoing primary percutaneous coronary intervention (PPCI). Methods and Results: This was a retrospective study of 303 STEMI patients who presented directly or were transferred to a tertiary hospital in Singapore for PPCI from October 2019 to March 2020. We compared the clinical outcomes of patients admitted before (BOR) and during (DOR) the COVID-19 outbreak response. The study outcomes were in-hospital death, D2B, cardiogenic shock and 30-day readmission. For direct presentations, fewer patients in the DOR group achieved D2B time <90 min compared with the BOR group (71.4% vs. 80.9%, P=0.042). This was more apparent after exclusion of non-system delay cases (DOR 81.6% vs. BOR 95.9%, P=0.006). Prevalence of both out-of-hospital cardiac arrest (9.5% vs. 1.9%, P=0.003) and acute mitral regurgitation (31.6% vs. 17.5%, P=0.006) was higher in the DOR group. Mortality was similar between groups. Multivariable regression showed that longer D2B time was an independent predictor of death (odds ratio 1.005, 95% confidence interval 1.000–1.011, P=0.029). Conclusions: The COVID-19 pandemic and the outbreak response have had an adverse effect on PPCI service efficiency. The study reinforces the need to focus efforts on shortening D2B time, while maintaining infection control measures.
Source Title: CIRCULATION JOURNAL
URI: https://scholarbank.nus.edu.sg/handle/10635/205776
ISSN: 13469843
13474820
DOI: 10.1253/circj.CJ-20-0800
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