MEDICAL SCIENCES
ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION DURING COVID-19 PANDEMIC The COVID-19 pandemic may have profound indirect consequences on the epidemiology, phenotype, and management of acute cardiovascular diseases. Our study shows, in a cardiovascular regional public service healthcare Hub, during COVID-19 pandemic, a significantly longer time from symptoms onset to hospital admission among patients with acute myocardial infarction compared to the same period in the previous two years. Mario Gramegna, Luca Baldetti Cardiac Intensive Care Unit, IRCCS San Raffaele Scientific Institute
T
he coronavirus disease 2019 (COVID-19) pandemic has an enormous impact on social, economic, and healthcare networks. Every sector of the healthcare system has been hit by the pandemic and must now face significant worldwide re-arrangements on access to cure and clinical priorities, including among the others, re-organisations of cardiovascular health systems. In particular, the 18
A SI A N H O S P I T A L & H EA LT HCA R E M A N AGE M E N T
Emergency Medical System (EMS) has been reshaped across the globe to optimise the management of COVID-19 patients and at the same time continue to guarantee adequate care for patients with acute cardiovascular conditions. Acute Coronary Syndromes (ACS) is the term used to define a range of cardiovascular conditions associated with a sudden reduction of blood flow (ischemia) to the heart muscle IS S UE - 52, 2021
(myocardium). One of these most serious conditions is acute ST-segment Elevation Myocardial Infarction (STEMI). It is a frequent disease still associated with high mortality, mandating rapid management with reperfusion therapy, with the aim to promptly restore blood flow to the ischemic myocardium. Reperfusion therapies encompass primary percutaneous coronary interventions (PCI) and fibrinolytic therapy. In the setting of STEMI, timely reperfusion therapy is crucial because a short ischemia time is associated with better clinical outcomes, lower short and long-term mortality. The impact of timing from the onset of symptoms to reperfusion as well as the creation of networks to supply around-the-clock fast access to primary PCI has definitely improved STEMI outcomes. Total delay from symptom onset to coronary reperfusion is both patient-dependent (delay from symptom onset to first
