• Oriol Rodríguez-Leor, Belén Cid-Álvarez, Armando Pérez de Prado, Xavier Rossello, Soledad Ojeda, Ana Serrador, Ramón López-Palop, Javier Martín-Moreiras, José Ramón Rumoroso, Ángel Cequier, Borja Ibáñez, Ignacio Cruz-González, Rafael Romaguera, Raúl Moreno, Working Group on the Infarct Code of the Interventional Cardiology Association of the Spanish Society of Cardiology Investigators, Manuel Villa, Rafael Ruíz-Salmerón, Francisco Molano, Carlos Sánchez, Erika Muñoz-García, Luís Íñigo, Juan Herrador, Antonio Gómez-Menchero, Juan Caballero, Mérida Cárdenas, Livia Gheorghe, Jesús Oneto, Francisco Morales, Félix Valencia, José Ramón Ruíz, José Antonio Diarte, Pablo Avanzas, Juan Rondán, Vicente Peral, Lucía Vera Pernasetti, Julio Hernández, Francisco Bosa, Pedro Luís Martín Lorenzo, Francisco Jiménez, Hernández José M de la Torre JMT Hospital Universitario Marqués de Valdecilla de Santander., Jesús Jiménez-Mazuecos, Fernando Lozano, José Moreu, Enrique Novo, Javier Robles, Moreiras Javier Martín JM Hospital de Universitario de Salamanca., Felipe Fernández-Vázquez, Ignacio J Amat-Santos, Joan Antoni Gómez-Hospital, Joan García-Picart, Blanco Bruno García Del BGD Hospital Universitari Vall d'Hebron., Ander Regueiro, Xavier Carrillo-Suárez, Helena Tizón, Mohsen Mohandes, Juan Casanova, Víctor Agudelo-Montañez, Juan Francisco Muñoz, Juan Franco, Roberto Del Castillo, Pablo Salinas, Jaime Elizaga, Fernando Sarnago, Santiago Jiménez-Valero, Fernando Rivero, Juan Francisco Oteo, Eduardo Alegría-Barrero, Ángel Sánchez-Recalde, Valeriano Ruíz, Eduardo Pinar, Ana Planas, Bernabé López Ledesma, Alberto Berenguer, Agustín Fernández-Cisnal, Pablo Aguar, Francisco Pomar, Miguel Jerez, Francisco Torres, Ricardo García, Araceli Frutos, Juan Miguel Ruíz Nodar, Koldobika García, Roberto Sáez, Alfonso Torres, Miren Tellería, Mario Sadaba, José Ramón López Mínguez, Juan Carlos Rama Merchán, Javier Portales, Ramiro Trillo, Guillermo Aldama, Saleta Fernández, Melisa Santás, and María Pilar Portero Pérez.
• Institut del Cor, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain; Centro de Investigación Biomédica en Red Enfermedades Cardiovaculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain; Institut de Recerca en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, Spain. Electronic address: oriolrodriguez@gmail.com.
• Rev Esp Cardiol (Engl Ed). 2020 Dec 1; 73 (12): 994-1002.

Introduction And ObjectivesThe COVID-19 outbreak has had an unclear impact on the treatment and outcomes of patients with ST-segment elevation myocardial infarction (STEMI). The aim of this study was to assess changes in STEMI management during the COVID-19 outbreak.MethodsUsing a multicenter, nationwide, retrospective, observational registry of consecutive patients who were managed in 75 specific STEMI care centers in Spain, we compared patient and procedural characteristics and in-hospital outcomes in 2 different cohorts with 30-day follow-up according to whether the patients had been treated before or after COVID-19.ResultsSuspected STEMI patients treated in STEMI networks decreased by 27.6% and patients with confirmed STEMI fell from 1305 to 1009 (22.7%). There were no differences in reperfusion strategy (> 94% treated with primary percutaneous coronary intervention in both cohorts). Patients treated with primary percutaneous coronary intervention during the COVID-19 outbreak had a longer ischemic time (233 [150-375] vs 200 [140-332] minutes, P<.001) but showed no differences in the time from first medical contact to reperfusion. In-hospital mortality was higher during COVID-19 (7.5% vs 5.1%; unadjusted OR, 1.50; 95%CI, 1.07-2.11; P <.001); this association remained after adjustment for confounders (risk-adjusted OR, 1.88; 95%CI, 1.12-3.14; P=.017). In the 2020 cohort, there was a 6.3% incidence of confirmed SARS-CoV-2 infection during hospitalization.ConclusionsThe number of STEMI patients treated during the current COVID-19 outbreak fell vs the previous year and there was an increase in the median time from symptom onset to reperfusion and a significant 2-fold increase in the rate of in-hospital mortality. No changes in reperfusion strategy were detected, with primary percutaneous coronary intervention performed for the vast majority of patients. The co-existence of STEMI and SARS-CoV-2 infection was relatively infrequent.Copyright © 2020 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

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