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Minerva Cardiology and Angiology 2022 August;70(4):421-7

DOI: 10.23736/S2724-5683.21.05516-2


language: English

Reduction in emergency access for acute myocardial infarction during the COVID-19 pandemic: a survey from the greater area of Rome

Achille GASPARDONE 1, Francesco VERSACI 2 , Fabrizio TOMAI 3, Giuseppe BIONDI-ZOCCAI 4, 5, Gregory A. SGUEGLIA 1, Gaetano GIOFFRÈ 1, Enrico ROMAGNOLI 6, Massimo MANCONE 7, Simone CALCAGNO 2, Igino PROIETTI 8, Alessandro SCIAHBASI 9, Riccardo DI PIETRO 2, Gaetano TANZILLI 7, Enrica MARIANO 10, Francesco ROMEO 10

1 Division of Cardiology, San Eugenio Hospital, Rome, Italy; 2 Division of Cardiology, Santa Maria Goretti Hospital, Latina, Italy; 3 Division of Cardiology, Aurelia Hospital, Rome, Italy; 4 Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University, Rome, Italy; 5 Mediterranea Cardiocentro, Naples, Italy; 6 Department of Cardiovascular and Thoracic Sciences, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy; 7 Department of Cardiovascular, Respiratory, Nephrological, Anesthetic and Geriatric Sciences, Sapienza University, Rome, Italy; 8 Division of Cardiology, M.G. Vannini Hospital, Rome, Italy; 9 Division of Cardiology, Sandro Pertini Hospital, Rome, Italy; 10 Division of Cardiology, Department of Medical Sciences, Tor Vergata University, Rome, Italy

BACKGROUND: On March 9, 2020, the Italian government imposed a national lockdown to tackle the COronaVIrus Disease 19 (COVID-19) pandemic, including stay at home recommendations. The precise impact of COVID-19 scare and lockdown on emergency access for acute myocardial infarction (MI) is still subject to debate.
METHODS: Data on all patients undergoing invasive coronary angiography at 9 hospitals in the greater area of Rome, Italy, between February 19, 2020 and March 29, 2020 were retrospectively collected. Incidence of ST-elevation MI (STEMI), and non-ST-elevation MI (NSTEMI), as well as corresponding percutaneous coronary intervention (PCI), was compared distinguishing two different 20-day time periods (before vs. on or after March 10, 2020).
RESULTS: During the study period, 1068 patients underwent coronary angiography, 142 (13%) with STEMI and 169 (16%) with NSTEMI. The average daily number of STEMI decreased from 4.3 before the lockdown to 2.9 after the lockdown (P=0.021). Similarly, the average daily number of NSTEMI changed from 5.0 to 3.5 (P=0.028). The average daily number of primary PCI changed from 4.2 to 2.9 (P=0.030), while the average daily number of PCI for NSTEMI changed from 3.5 to 2.5 (P=0.087). For STEMI patients, the time from symptom onset to hospital arrival (onset-to-door time less than three hours) showed a significant increase after the lockdown (P=0.018), whereas door-to-balloon time did not change significantly from before to after the lockdown (P=0.609).
CONCLUSIONS: The present study, originally reporting on the trends in STEMI and NSTEMI in the Rome area, highlights that significant decreases in the incidence of both acute coronary syndromes occurred between February 19, 2020 and March 29, 2020, together with increases in time from symptom onset to hospital arrival, luckily without changes in door-to-balloon time.

KEY WORDS: Acute coronary syndrome; COVID-19; Myocardial infarction

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