[논문]COVID-19 et SCA ST+

Hakim, R.; Motreff, P.; Rangé; , G.

doi:10.1016/j.ancard.2020.09.034

[해외논문] COVID-19 et SCA ST+
COVID-19 and STEMI 원문보기

Annales de cardiologie et d'angéiologie, v.69 no.6, 2020년, pp.355 - 359

Hakim, R. (Service de cardiologie, hô) , Motreff, P. (pitaux de Chartres) , Rangé, G. (Service de cardiologie, centre hospitalo-universitaire Gabriel-Montpied)

Abstract ▼ AI-Helper

Abstract The COVID-19 pandemic had an unexpected impact on cardiovascular emergencies, particularly STEMI. The France PCI registry and other studies around the world have highlighted a significant decrease in myocardial infarctions arriving at hospital. This decrease is mainly related to patients’ fear of coming to the hospital and being contaminated. Although the STEMI revascularisation time targets (<120min) are often difficult to achieve in normal times, they were almost impossible to achieve in periods of lockdown because of the many obstacles. Longer delays and longer total ischemic time have led to excess mortality, especially in the regions most affected by the epidemic. Recommendations for the management of STEMI during the COVID-19 period have thus been issued by the scientific societies. STEMI in patients with COVID-19 often have an uncommon clinical presentation, and the absence of coronary obstruction on angiography is frequent. Their prognosis is very poor. Only public information campaigns and an organisation adapted to the management of coronary emergencies during epidemics can try to limit their effects and avoid aggravating an already fragile health situation in the future.

Abstract

Résumé La pandémie du COVID-19 a eu un impact inattendu sur les urgences cardiovasculaires, en particulier le SCA ST+. Le registre France PCI et d’autres études à travers le monde ont mis en exergue une baisse notable des infarctus arrivant dans les structures hospitalières. Cette baisse est principalement liée à la peur des patients de venir à l’hôpital et d’y être contaminés. Si les objectifs de délais de revascularisation du SCA ST+ (<120min) sont souvent difficiles à tenir en temps normal, ils ont été quasi impossibles à atteindre en période de confinement, tant les obstacles étaient nombreux. L’allongement des délais et du temps total d’ischémie a conduit à une surmortalité, notamment dans les régions les plus affectées par l’épidémie. Des recommandations de prise en charge des SCA ST+ en période de COVID-19 ont ainsi été édictées par les sociétés savantes. Les SCA ST+ chez les patients porteurs du COVID-19 ont souvent une présentation clinique particulière et l’absence d’obstruction coronaire à l’angiographie est fréquente. Leur pronostic est très sombre. Seules des campagnes d’information du public et une organisation adaptée à la prise en charge des urgences coronaires en période épidémique pourront tenter d’en limiter les effets et éviter d’aggraver à l’avenir une situation sanitaire déjà fragilisée.

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