Abstract Background At the beginning of the COVID-19 pandemic, patients with myocardial infarction (MI) took longer to present to hospitals because of fear of contamination and health care access difficulties. Objectives To assess interventional cardiology procedures performed during the COVID-19 pandemic and its implications for MI approach. Methods Prospective registry of 24 cardiac catheterization laboratories in Brazil, with adult patients undergoing interventional cardiology procedures between May 26 and November 30, 2020. The outcomes were cardiovascular (CV) and non-CV complications, death, and MI. Concomitant COVID-19 was confirmed using RT-PCR. Machine learning techniques were used with nonparametric Classification Trees models, and Simple Correspondence Analysis, with R statistical software package. Significance level adopted of 5%. Results This study included 1282 patients, 435 of whom (33.9%) had MI as follows: ST-segment elevation MI (STEMI), 239 (54.9%); and non-ST-segment elevation MI (NSTEMI), 196 (45.1%). Of the 1282 patients, 29 had CV complications, 47 had non-CV complications, and 31 died. The diagnosis of COVID-19 was confirmed in 77 patients (6%), with 15.58% mortality and non-CV complications in 6.49%. Most patients had significant coronary artery disease (63%), and an intracoronary thrombus was more often found in the presence of STEMI (3.4%) and COVID-19 (4%). A door-to-table time longer than 12 hours in NSTEMI was associated with 30.8% of complications, 25% in COVID-19 patients. Conclusions All deaths were preceded by CV or non-CV complications. The presence of COVID-19 was associated with death and non-fatal complications of patients undergoing interventional cardiology procedures during the pandemic. COVID19 COVID 19 COVID-1 (MI difficulties approach 2 Brazil 30 2020 (CV nonCV non RTPCR. RTPCR RT PCR. PCR RT-PCR models Analysis package 5 5% 128 43 33.9% 339 33 9 (33.9% follows STsegment ST segment STEMI, , (STEMI) 23 54.9% 549 54 (54.9%) nonSTsegment NSTEMI, (NSTEMI) 45.1%. 451 45.1% . 45 1 (45.1%) 4 3 died 7 6%, 6 6% (6%) 1558 15 58 15.58 649 49 6.49% 63%, 63 63% (63%) 3.4% 34 (3.4% 4%. 4% (4%) doortotable door table 308 8 30.8 25 nonfatal fatal COVID1 COVID- 202 33.9 (33.9 (STEMI 54.9 (54.9% (NSTEMI 45.1 (45.1% (6% 155 15.5 64 6.49 (63% 3.4 (3.4 (4% 30. 20 33. (33. 54. (54.9 45. (45.1 (6 15. 6.4 (63 3. (3. (4 (33 (54. (45. ( 6. (3 (54 (45 (5
Resumo Fundamento No início da pandemia de COVID-19, os pacientes com infarto do miocárdio (IM) demoraram para procurar um hospital por medo de contágio ou dificuldades no acesso aos serviços de saúde. Objetivos Avaliar procedimentos de cardiologia intervencionista realizados durante a pandemia de COVID-19 e implicações na abordagem do IM. Métodos Registro prospectivo de 24 centros de hemodinâmica no Brasil, com pacientes adultos submetidos a procedimentos de cardiologia intervencionista entre 26 de maio e 30 de novembro de 2020. Os desfechos foram complicações cardiovasculares (CV) e não CV, morte e IM. A concomitância de COVID-19 foi confirmada com RT-PCR. Técnicas de machine learning foram usadas com modelos não paramétricos de árvores de classificação. Usou-se análise de correspondência simples com o software R. Adotou-se nível de significância de 5%. Resultados Este estudo incluiu 1.282 pacientes, 435 dos quais (33,9%) apresentaram IM: IM com supra de ST (IMCSST), 239 (54,9%); e IM sem supra de ST(IMSSST), 196 (45.1%). Dos 1.282 pacientes, 29 tiveram complicações CV, 47 tiveram complicações não CV e 31 morreram. O diagnóstico de COVID-19 foi confirmado em 77 pacientes (6%), com 15,58% de mortalidade e 6,49% de complicações não CV. A maioria dos pacientes apresentou significativa doença arterial coronariana (63%). Trombo intracoronariano foi mais frequente na presença de IMCSST (3,4%) e COVID-19 (4%). Tempo porta-mesa superior a 12 horas no IMSSST associou-se a 30,8% de complicações, 25% em pacientes com COVID-19. Conclusões Todos os óbitos foram precedidos por complicações CV ou não CV. A presença de COVID-19 foi associada a óbito e complicações não fatais dos pacientes submetidos a procedimentos de cardiologia intervencionista durante a pandemia. COVID19, COVID19 COVID 19, 19 (IM saúde COVID-1 2 Brasil 3 2020 (CV RTPCR. RTPCR RT PCR. PCR RT-PCR classificação Usouse Usou se R Adotouse Adotou 5 5% 1282 1 282 1.28 43 33,9% 339 33 9 (33,9% IMCSST, , (IMCSST) 23 54,9% 549 54 (54,9%) STIMSSST, STIMSSST ST(IMSSST) 45.1%. 451 45.1% . 45 (45.1%) 4 morreram 7 6%, 6 6% (6%) 1558 15 58 15,58 649 49 6,49 63%. 63 63% (63%) 3,4% 34 (3,4% 4%. 4% (4%) portamesa porta mesa associouse associou 308 8 30,8 25 COVID19. 19. COVID1 COVID- 202 128 28 1.2 33,9 (33,9 (IMCSST 54,9 (54,9% ST(IMSSST 45.1 (45.1% (6% 155 15,5 64 6,4 (63% 3,4 (3,4 (4% 30, 20 1. 33, (33, 54, (54,9 45. (45.1 (6 15, 6, (63 3, (3, (4 (33 (54, (45. ( (3 (54 (45 (5