STEMI admissions during COVID-19

New findings

Press release

“Patients’ fears of becoming infected by going to hospital must be addressed. They need to be assured that the in-hospital risk of coronavirus infection has been minimised for patients being admitted with heart attacks or strokes. If you have chest pain or other heart attack symptoms – such as pain in the throat, neck, back, stomach or shoulders that lasts for more than 15 minutes – you must call an ambulance. Remember that COVID-19 mortality is 10 times lower than that of an untreated heart attack. And rapid treatment for a heart attack works.” Professor Barbara Casadei, ESC President.

“Don’t delay if you have heart attack symptoms: call emergency. Every minute counts.”
Professor Dariusz Dudek, EAPCI President.

Download the press release 

Key findings of the research

The survey revealed that one of the main consequences of the pandemic was that fewer severe heart attack patients went to hospitals and that this phenomenon affected many hospitals.

• 78.8%  of respondents perceived a decrease in the number of STEMI patients coming to their hospitals
• According to them, the number of patients admitted to hospital had decreased by 50% on average

Many healthcare professionals also noted that STEMI patients who presented to hospitals did so later than usual.

• 62.3% of respondents declared that STEMI patients presented later than usual (i.e. beyond the window for percutaneous coronary intervention (PCI)/thrombolysis)
• The percentage of patients presenting later than usual was estimated to be 48% on average

Many cardiology departments have been impacted by the outbreak of the infection.

• Up to 68% of respondents stated that the cardiology department had been ”partially” or “totally” restructured to accommodate infected patients

Detailed results

Robust worldwide data.

The survey gathered data from 3,101 respondents in 141 countries on six continents. 

• 58% of respondents (n=1,800) were based in Europe
• Fairly robust data were also collected from Asia (n=734)

Most respondents were cardiologists and interventional cardiologists from large hospitals.

• More than 90% of respondents were cardiologists or interventional cardiologists
• Overall, less than 10% were nurses or population health scientists

Respondents mostly worked in university and regional hospitals.

• Only a minority of respondents worked in private hospitals (17% overall and 8% in Europe)

Most countries were locked-down at the time of the survey.

• 88% of respondents were “totally” locked-down especially in Europe and the Americas
• This was more strongly the case in Europe where 94% of respondents were in lockdown

Question: Is your country in lockdown (e.g. most shops and restaurants are closed, people are working from home as much as possible)?

Consequence #1 of the pandemic: There is a considerable decrease in STEMI patients coming to hospitals.

• Nearly 80% of respondents perceived a decrease in the number of STEMI patients coming to hospital
• Throughout the world, with only minor variations by geographical zones, most respondents reported a decrease in STEMI patients

Question: Have you perceived a change in the number of people coming to your hospital with STEMI since the coronavirus outbreak?

Respondents who noted a decrease in STEMI patients:

• Nearly 65% of respondents perceived a greater than 41% fall in STEMI patients presenting to hospital. Some observed much greater reductions. On average, there was a 50% drop in STEMI patients coming to hospital
• This was consistent throughout all regions except for South America where up to 75% declared a decrease of more than 41% in patients presenting with STEMI (with an average reaching 56% overall  in South America)

Question: By what percentage has the number of STEMI patients decreased?

Consequence #2 of the pandemic: STEMI patients present later than usual.

• 62% of respondents estimated that STEMI patients present later than usual
• In Europe, 64% of respondents said so vs. 54% in North America and 46% in Oceania

Question: Do STEMI patients present later than usual (i.e. beyond the optimal window for PCI/thrombolysis)?

Up to 65% of respondents estimated that at least 41% of STEMI patients present later than usual. Overall, on average, 48% of patients present later than usual. 

• The overall trend is relatively consistent throughout all regions except for North America where hospitals seemed somewhat less affected by this

Question: What percentage of STEMI patients present later than usual (i.e. beyond the optimal window for PCI/thrombolysis)?

Consequence #3 of the pandemic: the huge wave of COVID patients also impacted cardiology departments.

• Europe was the area with the most infected patients: up to 15% of respondents said that more than 200 infected patients were admitted to their hospital
• In Europe alone, half of the respondents estimated that their hospital had received at least 51 infected patients

Question: How many patients are currently admitted to your hospital with COVID-19?

Up to 68% of respondents stated that their unit had been either “partially” or “totally” restructured as a result of the pandemic.

• This trend was strongest in the Americas

Question: Has your ward/unit/department been restructured as a result of the COVID-19 pandemic?

For those reporting an increase in STEMI patients, the increase was marginal.

• Only 3% of respondents reported an increase in STEMI patients
• For up to 78% of those respondents who saw an increase, that increase ranged from 1% to 40%
• There were many regional differences, but the samples are too small to be statistically comparable 

Question: By what percentage has the number of STEMI patients increased?

Only 3% of all respondents reported an increase in STEMI patients. For 30% of those respondents, the main reason for the increase in STEMI patients was “anxiety”.

• Although the reported increase in STEMI patients was not statistically significant, 21% of European respondents indicated the key reason was “more STEMIs happening” followed by “health anxiety” (18%)

Question: What do you think the reasons for an increase are?

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  Mean % of results

 Increase/decrease of STEMI patients’ admissions in hospitals in countries with National (NCS) and Affiilated (ACS) Cardiac Societies.