IMR Press / RCM / Volume 24 / Issue 2 / DOI: 10.31083/j.rcm2402054
Open Access Systematic Review
ST-Segment Elevation Myocardial Infarction (STEMI) Management in the Era of COVID-19: A Systematic and Critical Review of Published Guidance Reports
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1 Third Department of Medicine, School of Medicine, National and Kapodistrian University of Athens, Sotiria Hospital, 11527 Athens, Greece
2 1st Department of Cardiology, Athens Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 11527 Athens, Greece
*Correspondence: konkyriakoulis@gmail.com (Konstantinos G Kyriakoulis)
Rev. Cardiovasc. Med. 2023, 24(2), 54; https://doi.org/10.31083/j.rcm2402054
Submitted: 6 October 2022 | Revised: 25 November 2022 | Accepted: 28 November 2022 | Published: 6 February 2023
(This article belongs to the Special Issue Cardiovascular Health and COVID-19)
Copyright: © 2023 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Background: Coronavirus disease 2019 (COVID-19) had a major impact on healthcare systems worldwide. During the early phase of the pandemic many elective procedures were postponed. At the same time, the safe and effective management of medical emergencies such as ST-segment elevation myocardial infarction (STEMI) has been a challenge. Methods: A systematic literature search was conducted aiming to identify published guidance reports by national or international societies regarding the management of patients suffering STEMI in the era of COVID-19. Results: Among 1681 articles initially retrieved, six fulfilled the inclusion criteria and were included in the systematic review. Two reports were international consensus documents, while four reports were national guidance statements from Asian countries (Taiwan, India, Iran, and China). Most documents were drafted during the early phase of the pandemic. According to the international consensus documents, percutaneous coronary intervention (PCI) should be regarded as the reperfusion method of choice. On the other hand, in three out of four national consensus statements (Taiwan, Iran and China) fibrinolysis was considered as the reperfusion method of choice for STEMI in suspected/confirmed patients with COVID-19, unless contraindicated or in the presence of high cardiovascular risk clinical features. Authors of all documents underlined the need for early COVID-19 testing in patients with STEMI to better determine the next therapeutical steps. Conclusions: National and international consensus statements for STEMI management in the era of COVID-19 have been published mainly during the early peak phase of the pandemic. Authors recognise that these recommendations are mainly based on expert opinions and observational data. As global immunization rates increase and methods for rapid COVID-19 detection are widely available, the implementation of traditional evidence-based practices used before the pandemic is becoming more feasible.

Keywords
consensus
COVID-19
fibrinolysis
guideline
percutaneous coronary intervention
STEMI
Figures
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