Examining the Effects of COVID-19 Pandemic on ST Segment-elevation Myocardial Infarction Treatment Strategies with the Impact of Event Scale

Objective: Primary percutaneous coronary intervention (PPCI) is the first-line recommended therapy for acute ST-segment-elevation myocardial infarction (STEMI). While some papers have suggested to continue performing PPCI for patients with STEMI, some papers highlighted using lytic therapy during the earlier pandemic period. The points underestimated in these publications were the psychological impact of the coronavirus disease-2019 (COVID-19) pandemic on cardiologists and their STEMI treatment strategies. Based on this idea, we searched an answer to this question. This document evaluated STEMI treatment strategies using the Impact of Event Scale (IES) during the early stages of the COVID-19 pandemic.
Methods: An online, questionnaire study conducted randomly to 1000 cardiologists via e-mail or WhatsApp message to evaluate cardiologists’ STEMI treatment strategies with five psychological factors [daily moods (F1), willingness and ability to work (F2), anxiety about infection (F3), lack of medical information (F4), and feeling of being protected (F5)] which were filled between 01-15 May 2020 by 136 volunteers in Turkey.
Results: Turkish invasive cardiologists major treatment choice for patients with STEMI were PPCI during the early pandemic period, even they felt worse all in all, less willingness to work, and higher anxiety about infection, which means higher total IES, F1, F2, and F3 scores in the study. Different psychological impacts of COVID-19 pneumonia had different effects on cardiologists’ treatment strategies. The F3 score was the major determinant psychological factor for the STEMI treatment strategy. The participants with the highest F3 scores [10.0 (9.0-11.0)] preferred thrombolytic therapy.
Conclusion: This unique study evaluating cardiologists real-life STEMI treatment strategies using the IES during the COVID-19 pandemic showed that lytic therapy came to the fore again for the cardiologists with the highest anxiety level about COVID-19 pneumonia in real-life.