ArticleInternational journal of cardiology. Heart & vasculature2020
Management of acute coronary syndromes during the COVID-19 outbreak in Lombardy: The "macro-hub" experience.
Article in International journal of cardiology. Heart & vasculature, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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11 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.
- Comparison of the Characteristics, Management, and Outcomes of STEMI Patients Presenting With vs. Those of Patients Presenting Without COVID-19 Infection: A Systematic Review and Meta-Analysis.Frontiers in cardiovascular medicine · 2022Pooled it
- Epidemiological, clinical, and economic burden of myocardial infarction patients in Iran during the COVID-19 pandemic.International journal of cardiology. Heart & vasculature · 2023Article
- Recent highlights on myocarditis, cardiovascular complications of COVID-19, and cardiomyopathies from the International Journal of Cardiology: Heart & Vasculature.International journal of cardiology. Heart & vasculature · 2022Article
- The Challenge of High Coronary Thrombotic Events in Patients with ST-Segment Elevation Myocardial Infarction and COVID-19.Journal of clinical medicine · 2022Article
- Acute coronary syndromes during the first and the second wave of COVID-19.European journal of internal medicine · 2022Article
- Influence of Different COVID-19 Pandemic Phases on STEMI: Experience From an Italian Hub Centre.Cardiovascular revascularization medicine : including molecular interventions · 2022Article
- Acute Coronary Syndromes and SARS-CoV-2 Infection: Results From an Observational Multicenter Registry During the Second Pandemic Spread in Lombardy.Frontiers in cardiovascular medicine · 2022Article
- Indirect impact of Covid-19 on hospital care pathways in Italy.Scientific reports · 2021Article
- The other side of the coin: 'centralization' against 'optimization' in COVID-19 pandemic.ESC heart failure · 2021Article
- Acute Myocardial Infarction During the COVID-19 Pandemic: An Update on Clinical Characteristics and Outcomes.Frontiers in cardiovascular medicine · 2021Review
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Authors and funding
20 authors at 12 institutions in 1 country.
Funding
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Abstract
backgroundDuring the COVID-19 outbreak, healthcare Authorities of Lombardy modified the regional network concerning time-dependent emergencies. Specifically, 13 Macro-Hubs were identified to deliver timely optimal care to patients with acute coronary syndromes (ACS). Aim of this paper is to present the results of this experience. METHODS AND
resultsThis is a multicenter, observational study. A total of 953 patients were included, presenting with STEMI in 57.7% of the cases. About 98% of patients received coronary angiography with a median since first medical contact to angiography of 79 (IQR 45-124) minutes for STEMI and 1262 (IQR 643-2481) minutes for NSTEMI.A total of 107 patients (11.2%) had SARS-CoV2 infection, mostly with STEMI (74.8%). The time interval from first medical contact to cath-lab was significant shorter in patients with COVID-19, both in the overall population and in STEMI patients (87 (IQR 41-310) versus 160 (IQR 67-1220) minutes, P = 0.001, and 61 (IQR 23-98) versus 80 (IQR 47-126) minutes, P = 0.01, respectively). In-hospital mortality and cardiogenic shock rates were higher among patients with COVID-19 compared to patients without (32% vs 6%, P < 0.0001, and 16.8% vs 6.7%, P < 0.0003, respectively).
conclusionsDuring the COVID-19 outbreak in Lombardy, the redefinition of ACS network according to enlarged Macro-Hubs allowed to continue with timely ACS management, while reserving a high number of intensive care beds for the pandemic. Patients with ACS and COVID-19 presented a worst outcome, particularly in case of STEMI.
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