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经皮冠状动脉介入治疗的 COVID-19 患者的临床和操作特点。

Clinical and procedural characteristics of COVID-19 patients treated with percutaneous coronary interventions.

机构信息

Collegium Medicum, Jan Kochanowski University in Kielce, Kielce, Poland.

First Department of Cardiology, Poznan University of Medical Sciences, Poznan, Poland.

出版信息

Catheter Cardiovasc Interv. 2020 Nov;96(6):E568-E575. doi: 10.1002/ccd.29134. Epub 2020 Jul 20.

Abstract

BACKGROUND

COVID-19 pandemic has affected healthcare systems worldwide. Resources are being shifted and potentially jeopardize safety of non-COVID-19 patients with comorbidities. Our aim was to investigate the impact of national lockdown and SARS-CoV-2 pandemic on percutaneous treatment of coronary artery disease in Poland.

METHODS

Data on patients who underwent percutaneous coronary procedures (angiography and/or percutaneous coronary intervention [PCI]) were extracted for March 13-May 13, 2020 from a national PCI database (ORPKI Registry) during the first month of national lockdown and compared with analogous time period in 2019.

RESULTS

Of 163 cardiac catheterization centers in Poland, 15 (9.2%) were indefinitely or temporarily closed down due to SARS-CoV-2 pandemic. There were nine physicians (9 of 544; 1.7%) who were infected with SARS-CoV-2. There were 13,750 interventional cardiology procedures performed in Poland in the analyzed time period. In 66% of cases an acute coronary syndrome was diagnosed, and in the remaining 34% it was an elective procedure for the chronic coronary syndrome in comparison to 50% in 2019 (p < .001). There were 362 patients (2.6% of all) with COVID-19 confirmed/suspected who were treated in interventional cardiology centers and 145 with ST-Elevation Myocardial Infarction (STEMI) diagnosis (6% of all STEMIs).

CONCLUSIONS

Due to SARS-CoV-2 pandemic there was an absolute reduction in the number of interventional procedures both acute and elective in comparison to 2019 and a significant shift into acute procedures. COVID-19 confirmed/suspected patients do not differ in terms of procedural and baseline characteristics and reveal similar outcomes when treated with percutaneous coronary interventions.

摘要

背景

COVID-19 大流行已对全球医疗体系造成影响。资源正在转移,可能危及合并症非 COVID-19 患者的安全。我们的目的是研究国家封锁和 SARS-CoV-2 大流行对波兰经皮冠状动脉疾病治疗的影响。

方法

从国家 PCI 数据库(ORPKI 注册表)中提取 2020 年 3 月 13 日至 5 月 13 日期间实施经皮冠状动脉介入治疗(血管造影和/或经皮冠状动脉介入治疗 [PCI])的患者数据,并与 2019 年同期进行比较。

结果

在波兰的 163 个心脏导管插入术中心中,有 15 个(9.2%)因 SARS-CoV-2 大流行而无限期或暂时关闭。有 9 名医生(544 名中的 9 名;1.7%)感染了 SARS-CoV-2。在分析期间,波兰共进行了 13750 例介入心脏病学手术。在 66%的病例中诊断为急性冠状动脉综合征,而在其余 34%的病例中为慢性冠状动脉综合征的择期手术,而 2019 年为 50%(p < 0.001)。有 362 名(所有患者的 2.6%)COVID-19 确诊/疑似患者在介入心脏病学中心接受治疗,145 名患有 ST 段抬高型心肌梗死(STEMI)诊断(所有 STEMI 的 6%)。

结论

由于 SARS-CoV-2 大流行,与 2019 年相比,无论是急性还是择期介入手术的数量都绝对减少,并且明显转为急性手术。COVID-19 确诊/疑似患者在手术和基线特征方面没有差异,并且经皮冠状动脉介入治疗后结果相似。

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