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Editorial
The STEMI phenomenon during the COVID-19 pandemic: what is beneath the tip of the iceberg?
  1. Victoria L. Cammann,
  2. Christian Templin
  1. Department of Cardiology, University Hospital Zurich, Zurich, Switzerland
  1. Correspondence to Prof. Christian Templin, University Heart Center, Department of Cardiology, University Hospital Zurich, 8091 Zurich, Switzerland; christian.templin{at}usz.ch

https://doi.org/10.1136/heartjnl-2021-320383

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    SARS-CoV-2, the causative agent of COVID-19, is associated with substantial cardiovascular risk and can be accompanied by acute coronary syndromes (ACS), takotsubo syndrome, myocarditis and spontaneous coronary artery dissection.1–4 The outbreak of the COVID-19 pandemic resulted in an enormous reorganisation of healthcare facilities, limiting access to emergency treatment and reducing or even halting elective procedures. ST-segment elevation myocardial infarction (STEMI) is a critical, time-dependent emergency and prompt referral for primary percutaneous coronary intervention (PPCI) is key for optimal management. Globally, a drop of ACS cases during the COVID-19 pandemic was noticed. High-quality data were initially reported from the International Study on Acute Coronary Syndromes–ST Elevation (ISACS-STEMI) COVID-19, which is a multinational multicentre retrospective registry aiming to provide a snapshot of incidence estimates and outcomes of STEMI during the COVID-19 pandemic. In their initial report, the authors described a reduction of PPCI procedures, delays in STEMI treatment and an increased in-hospital mortality in Europe during the COVID-19 pandemic compared with a pre-pandemic period.5

    De Luca and colleagues6 now report in the journal a follow-up study and the final results of the ISACS-STEMI COVID-19 Registry in which they have re-examined the incidence rates of patients with STEMI undergoing PPCI, delayed treatment (defined as ischaemia time over 12 hours and …

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    Footnotes

    • Contributors VLC and CT drafted the manuscript. VLC and CT prepared the figure. VLC and CT read and approved the final version of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests CT reports receiving fees outside the submitted work for serving on advisory boards from AstraZeneca and Amgen; serving as a consultant for Schnell Medical and Shockwave; travel support from Abbott Vascular, Biosensors, Boston Scientific, Edwards Lifesciences and Medtronic; and research grant support from Abbott Vascular.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting or dissemination plans of this research.

    • Provenance and peer review Commissioned; externally peer reviewed.

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