• Guillaume Bonnet, Vassili Panagides, Mathieu Becker, Nicolas Rivière, Cédric Yvorel, Antoine Deney, Benoit Lattuca, Benjamin Duband, Karim Moussa, Léa Juenin, Thibault Pamart, Carl Semaan, Sabrina Uhry, Nathalie Noirclerc, Flavien Vincent, Maxime Vignac, Vincenzo Palermo, Anne Sophie Martin, Michel Zeitouni, Eric Van Belle, Ashok Tirouvanziam, Aurélie Manchuelle, Chekrallah Chamandi, Mathieu Kerneis, Madjid Boukantar, Loïc Belle, Fabien De Poli, Denis Angoulvant, Nicolas Meneveau, Marie Robin, Michel Pansieri, Laurent Bonello, Pascal Motreff, Frédéric Bouisset, Karl Isaaz, Laura Cetran, Khalifé Khalife, Pierluigi Lesizza, Julien Adjedj, Hakim Benamer, Guillaume Cayla, and MODIF registry investigators.
• Université de Paris, Paris Cardiovascular Research Center (PARCC), INSERM, UMR-S970, 75015 Paris, France.
• Arch Cardiovasc Dis. 2021 May 1; 114 (5): 340-351.

BackgroundSystems of care have been challenged to control progression of the COVID-19 pandemic. Whether this has been associated with delayed reperfusion and worse outcomes in French patients with ST-segment elevation myocardial infarction (STEMI) is unknown.AimTo compare the rate of STEMI admissions, treatment delays, and outcomes between the first peak of the COVID-19 pandemic in France and the equivalent period in 2019.MethodsIn this nationwide French survey, data from consecutive STEMI patients from 65 centres referred for urgent revascularization between 1 March and 31 May 2020, and between 1 March and 31 May 2019, were analysed. The primary outcome was a composite of in-hospital death or non-fatal mechanical complications of acute myocardial infarction.ResultsA total of 6306 patients were included. During the pandemic peak, a 13.9±6.6% (P=0.003) decrease in STEMI admissions per week was observed. Delays between symptom onset and percutaneous coronary intervention were longer in 2020 versus 2019 (270 [interquartile range 150-705] vs 245 [140-646]min; P=0.013), driven by the increase in time from symptom onset to first medical contact (121 [60-360] vs 150 [62-420]min; P=0.002). During 2020, a greater number of mechanical complications was observed (0.9% vs 1.7%; P=0.029) leading to a significant difference in the primary outcome (112 patients [5.6%] in 2019 vs 129 [7.6%] in 2020; P=0.018). No significant difference was observed in rates of orotracheal intubation, in-hospital cardiac arrest, ventricular arrhythmias and cardiogenic shock.ConclusionsDuring the first peak of the COVID-19 pandemic in France, there was a decrease in STEMI admissions, associated with longer ischaemic time, exclusively driven by an increase in patient-related delays and an increase in mechanical complications. These findings suggest the need to encourage the population to seek medical help in case of symptoms.Copyright © 2021 Elsevier Masson SAS. All rights reserved.

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