The recent COVID-19 poll asked if respondents have seen a reduction in ST-segment elevation myocardial infarction (STEMI) presentations since the beginning of the COVID-19 pandemic. While this poll was on the site, data from 9 US centers were published in the Journal of the American College of Cardiology¹ that documented a 38% decline in STEMI presentations. Similar declines have also been reported in other countries, including Spain² and Austria.³

Of the roughly 500 respondents, only 6% noted no decline in STEMI presentations. Of those who did note a decline, 23% thought there had been a <50% reduction, 56% thought there had been a >50% reduction, and 15% thought that there were essentially no STEMI cases being seen. Regarding reasons for the decline, about half of respondents attributed it to under-recognition due to late presentations. Less job stress because of stay-at-home orders was the major reason according to 32% of respondents, and 18% felt that patients were going to and/or being transferred to smaller hospitals to protect bed availability in larger hospitals prepared for patients with COVID-19.

As always, thanks to the participants. These results pose some interesting questions: Are we seeing even fewer STEMIs than we think? Do environmental circumstances play a role? Going forward, we will hopefully start to understand the dynamics involved in these results.

References

1. Garcia S, Albaghdadi MS, Meraj PM, et. al. Reduction in ST-Segment Elevation Cardiac Catheterization Laboratory Activations in the United States during COVID-19 Pandemic. J Am Coll Cardiol 2020;Apr 9:[Epub ahead of print].
2. Rodríguez-Leora O, Cid-Álvarez B, Ojeda S, et al. Impacto de la pandemia de COVID-19 sobre la actividad asistencial en cardiología intervencionista en España. REC Interv Cardiol 2020;Apr 4:[Epub ahead of print].
3. Metzler B, Siostrzonek P, Binder RK, Bauer A, Reinstadler SJ. Decline of acute coronary syndrome admissions in Austria since the outbreak of COVID-19: the pandemic response causes cardiac collateral damage. Eur Heart J 2020;Apr 16:[Epub ahead of print].

Clinical Topics: COVID-19 Hub, Invasive Cardiovascular Angiography and Intervention, Noninvasive Imaging, Stable Ischemic Heart Disease, Vascular Medicine, Interventions and Imaging, Interventions and Vascular Medicine, Angiography, Nuclear Imaging, Chronic Angina

Keywords: Coronary Angiography, ST Elevation Myocardial Infarction, COVID-19, Coronavirus, severe acute respiratory syndrome coronavirus 2

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