Dataset Information

Gender Difference in the Effects of COVID-19 Pandemic on Mechanical Reperfusion and 30-Day Mortality for STEMI: Results of the ISACS-STEMI COVID-19 Registry.

ABSTRACT:

Background

Several reports have demonstrated the impact of the COVID-19 pandemic on the management and outcome of patients with ST-segment elevation myocardial infarction (STEMI). The aim of the current analysis is to investigate the potential gender difference in the effects of the COVID-19 pandemic on mechanical reperfusion and 30-day mortality for STEMI patients within the ISACS-STEMI COVID-19 Registry.

Methods

This retrospective multicenter registry was performed in high-volume primary percutaneous coronary intervention (PPCI) centers on four continents and included STEMI patients undergoing PPCIs in March-June 2019 and 2020. Patients were divided according to gender. The main outcomes were the incidence and timing of the PPCI, (ischemia time ≥ 12 h and door-to-balloon ≥ 30 min) and in-hospital or 30-day mortality.

Results

We included 16683 STEMI patients undergoing PPCIs in 109 centers. In 2020 during the pandemic, there was a significant reduction in PPCIs compared to 2019 (IRR 0.843 (95% CI: 0.825-0.861, p < 0.0001). We did not find a significant gender difference in the effects of the COVID-19 pandemic on the numbers of STEMI patients, which were similarly reduced from 2019 to 2020 in both groups, or in the mortality rates. Compared to prepandemia, 30-day mortality was significantly higher during the pandemic period among female (12.1% vs. 8.7%; adjusted HR [95% CI] = 1.66 [1.31-2.11], p < 0.001) but not male patients (5.8% vs. 6.7%; adjusted HR [95% CI] = 1.14 [0.96-1.34], p = 0.12).

Conclusions

The COVID-19 pandemic had a significant impact on the treatment of patients with STEMI, with a 16% reduction in PPCI procedures similarly observed in both genders. Furthermore, we observed significantly increased in-hospital and 30-day mortality rates during the pandemic only among females. Trial registration number: NCT 04412655.

SUBMITTER: De Luca G

PROVIDER: S-EPMC9918240 | biostudies-literature | 2023 Jan

REPOSITORIES: biostudies-literature

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Publications

Gender Difference in the Effects of COVID-19 Pandemic on Mechanical Reperfusion and 30-Day Mortality for STEMI: Results of the ISACS-STEMI COVID-19 Registry.

De Luca Giuseppe G Manzo-Silberman Stephane S Algowhary Magdy M Uguz Berat B Oliveira Dinaldo C DC Ganyukov Vladimir V Busljetik Oliver O Cercek Miha M Okkels Lisette L Loh Poay Huan PH Calmac Lucian L Ferrer Gerard Roura I GRI Quadros Alexandre A Milewski Marek M Scotto di Uccio Fortunato F von Birgelen Clemens C Versaci Francesco F Ten Berg Jurrien J Casella Gianni G Wong Sung Lung Aaron A Kala Petr P Díez Gil José Luis JL Carrillo Xavier X Dirksen Maurits M Becerra Victor V Lee Michael Kang-Yin MK Juzar Dafsah Arifa DA de Moura Joaquim Rodrigo R Paladino Roberto R Milicic Davor D Davlouros Periklis P Bakraceski Nikola N Zilio Filippo F Donazzan Luca L Kraaijeveld Adriaan A Galasso Gennaro G Arpad Lux L Marinucci Lucia L Guiducci Vincenzo V Menichelli Maurizio M Scoccia Alessandra A Yamac Aylin Hatice AH Ugur Mert Kadir K Flores Rios Xacobe X Kovarnik Tomas T Kidawa Michal M Moreu Josè J Flavien Vincent V Fabris Enrico E Martínez-Luengas Iñigo Lozano IL Boccalatte Marco M Ojeda Francisco Bosa FB Arellano-Serrano Carlos C Caiazzo Gianluca G Cirrincione Giuseppe G Kao Hsien-Li HL Forés Juan Sanchis JS Vignali Luigi L Pereira Helder H Ordoñez Santiago S Arat Özkan Alev A Scheller Bruno B Lehtola Heidi H Teles Rui R Mantis Christos C Antti Ylitalo Y Brum Silveira João António JA Zoni Cesar Rodrigo CR Bessonov Ivan I Uccello Giuseppe G Kochiadakis George G Alexopulos Dimitrios D Uribe Carlos E CE Kanakakis John J Faurie Benjamin B Gabrielli Gabriele G Barrios Alejandro Gutierrez AG Bachini Juan Pablo JP Rocha Alex A Tam Frankie C C FCC Rodriguez Alfredo A Lukito Antonia Anna AA Saint-Joy Veauthyelau V Pessah Gustavo G Tuccillo Andrea A Ielasi Alfonso A Cortese Giuliana G Parodi Guido G Bouraghda Mohamed Abed MA Moura Marcia M Kedhi Elvin E Lamelas Pablo P Suryapranata Harry H Nardin Matteo M Verdoia Monica M

Journal of clinical medicine 20230123 3

<h4>Background</h4>Several reports have demonstrated the impact of the COVID-19 pandemic on the management and outcome of patients with ST-segment elevation myocardial infarction (STEMI). The aim of the current analysis is to investigate the potential gender difference in the effects of the COVID-19 pandemic on mechanical reperfusion and 30-day mortality for STEMI patients within the ISACS-STEMI COVID-19 Registry.<h4>Methods</h4>This retrospective multicenter registry was performed in high-volum ...[more]

PMID: 36769546

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Project description:BackgroundIt has been suggested the COVID pandemic may have indirectly affected the treatment and outcome of STEMI patients, by avoidance or significant delays in contacting the emergency system. No data have been reported on the impact of diabetes on treatment and outcome of STEMI patients, that was therefore the aim of the current subanalysis conducted in patients included in the International Study on Acute Coronary Syndromes-ST Elevation Myocardial Infarction (ISACS-STEMI) COVID-19.MethodsThe ISACS-STEMI COVID-19 is a retrospective registry performed in European centers with an annual volume of > 120 primary percutaneous coronary intervention (PCI) and assessed STEMI patients, treated with primary PCI during the same periods of the years 2019 versus 2020 (March and April). Main outcomes are the incidences of primary PCI, delayed treatment, and in-hospital mortality.ResultsA total of 6609 patients underwent primary PCI in 77 centers, located in 18 countries. Diabetes was observed in a total of 1356 patients (20.5%), with similar proportion between 2019 and 2020. During the pandemic, there was a significant reduction in primary PCI as compared to 2019, similar in both patients with (Incidence rate ratio (IRR) 0.79 (95% CI: 0.73-0.85, p < 0.0001) and without diabetes (IRR 0.81 (95% CI: 0.78-0.85, p < 0.0001) (p int = 0.40). We observed a significant heterogeneity among centers in the population with and without diabetes (p < 0.001, respectively). The heterogeneity among centers was not related to the incidence of death due to COVID-19 in both groups of patients. Interaction was observed for Hypertension (p = 0.024) only in absence of diabetes. Furthermore, the pandemic was independently associated with a significant increase in door-to-balloon and total ischemia times only among patients without diabetes, which may have contributed to the higher mortality, during the pandemic, observed in this group of patients.ConclusionsThe COVID-19 pandemic had a significant impact on the treatment of patients with STEMI, with a similar reduction in primary PCI procedures in both patients with and without diabetes. Hypertension had a significant impact on PCI reduction only among patients without diabetes. We observed a significant increase in ischemia time and door-to-balloon time mainly in absence of diabetes, that contributed to explain the increased mortality observed in this group of patients during the pandemic.Trial registration numberNCT04412655.

Project description:This study examine the psychological distress experience of Nigerians during the COVID-19 pandemic, across gender. From March 20, 2020, to April 12, 2020, this descriptive survey used a snowballing sampling technique to select 502-Nigerians with an online semi-structured questionnaire detailing the impact of Event Scale-Revised, Generalized Anxiety Disorder - 7 item scale, Patient Health Questionnaire and Insomnia Severity Index. Gender had an insignificant difference in the level of insomnia (χ2 = 04.93; df = 3; p > 0.05), however, 20.8% of males had sub-threshold of insomnia, 8.2% experienced moderate insomnia and 5.9% had severe insomnia; 32% females reported sub-threshold of insomnia, 12.4% had moderate insomnia while 3.6% had severe insomnia. Also, gender had an insignificant difference in the measures of depression (χ2 = 01.94; df = 4; p > 0.05); 55.4% males reported minimal depression, 22.3% had mild depression, 11.9% had moderate depression; 6.7%-3.7% males had moderate to severe depression while, 49.3% of the females had minimal depression, 26.7% reported mild depression, 14.29% had moderate depression, 4.4%-5.3% had moderate to severe depressive symptoms. Posttraumatic Stress Symptoms (PTSS) has no gender difference among respondents (χ2 = 02.51; df = 3; p > 0.05); 23% of males reported partial PTSS, 17.5% presented clinical PTSS, and 21.6% males had severe PTSS; while 29.3% of females had severe PTSS, 24% reported partial PTSS and 18.7% had clinical PTSS. Respondents reported insignificant gender differences on anxiety (χ2 = 0.08; df = 1; p > 0.05), while 51% reported moderate anxiety and 49% exhibited severe anxiety during the COVID-19 pandemic in Nigeria. Findings revealed that Nigerians experienced psychological distress during COVID-19 pandemic. The government and stakeholders should initiate tele-mental health services to serve as alternative to traditional treatment to manage present and future pandemic psychological implications among Nigerians.

Dataset Information

Gender Difference in the Effects of COVID-19 Pandemic on Mechanical Reperfusion and 30-Day Mortality for STEMI: Results of the ISACS-STEMI COVID-19 Registry.

Background

Methods

Results

Conclusions

Publications

Gender Difference in the Effects of COVID-19 Pandemic on Mechanical Reperfusion and 30-Day Mortality for STEMI: Results of the ISACS-STEMI COVID-19 Registry.

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