FIBRINOLYTIC THERAPY FOR ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION DURING THE COVID-19 PANDEMIC: A SINGLE-CENTER EXPERIENCE

Purpose: Coronavirus Disease 2019 (COVID-19) is a rapidly expanding global pandemic and dramatically altered the delivery of reperfusion therapy for patients with ST-segment–elevation myocardial infarction (STEMI). The aim of this study is to analysis role of fibrinolytic therapy in STEMI patients during COVID-19 Pandemic.
Research Methodology: This is a single centre prospective study in Dr. M. Djamil General Hospital (Padang, Indonesia), with included all patients presenting with suspected COVID 19 with STEMI followed fibrinolytic therapy between 1 April to 30 May 2020 (during COVID-19 pandemic) and compare same periode in 2019. The primary outcome will be in- hospital major adverse cardiovascular events (MACE) defined as as composite of all-cause mortality, stroke, recurrent MI, unstable angina, heart failure, cardiogenic shock and or cardiac arrest. Secondary outcomes were MACE within 3 months follow-up.
Results: A total of 20 patients were included in the final analysis. Mean age was 56.70 ± 8.74 years. Male were 75%, hypertensive 60%, smoker 55%, diabetes mellitus 45%. During the pandemic period from April to May 2020, there was an approximately 64% drop STEMI cases compared to the same period in 2019. There were 15 patients (75%) who had failed. In primary outcome, there is no incidence of in-hospital MACE. Secondary outcomes were reported 2 patient with MACE incidence within 3 months follow-up.
Conclusion: Fibrinolytic therapy is the choice of reperfusion therapy in early COVID-19 pandemic era and relatively still had a good prognosis in case of MACE incidence