Gender Difference in the Effects of COVID-19 Pandemic on Mechanical Reperfusion and 30-Day Mortality for STEMI: Results of the ISACS-STEMI COVID-19 Registry
Authors: De Luca Giuseppe , Manzo-Silberman Stephane , Algowhary Magdy , Uguz Berat , Oliveira Dinaldo C. , Ganyukov Vladimir , Busljetik Oliver , Cercek Miha , Okkels Lisette , Loh Poay Huan , Calmac Lucian , Ferrer Gerard Roura i , Quadros Alexandre , Milewski Marek , Scotto di Uccio Fortunato , von Birgelen Clemens , Versaci Francesco , Ten Berg Jurrien , Casella Gianni , Wong Sung Lung Aaron , Kala Petr , Díez Gil José Luis , Carrillo Xavier , Dirksen Maurits , Becerra Victor , Lee Michael Kang-yin , Juzar Dafsah Arifa , de Moura Joaquim Rodrigo , Paladino Roberto , Milicic Davor , Davlouros Periklis , Bakraceski Nikola , Zilio Filippo , Donazzan Luca , Kraaijeveld Adriaan , Galasso Gennaro , Arpad Lux , Marinucci Lucia , Guiducci Vincenzo , Menichelli Maurizio , Scoccia Alessandra , Yamac Aylin Hatice , Ugur Mert Kadir , Flores Rios Xacobe , Kovarnik Tomas , Kidawa Michal , Moreu Josè , Flavien Vincent , Fabris Enrico , Martínez-Luengas Iñigo Lozano , Boccalatte Marco , Ojeda Francisco Bosa , Arellano-Serrano Carlos , Caiazzo Gianluca , Cirrincione Giuseppe , Kao Hsien-Li , Forés Juan Sanchis , Vignali Luigi , Pereira Helder , Ordoñez Santiago , Arat Özkan Alev , Scheller Bruno , Lehtola Heidi , Teles Rui , Mantis Christos , Antti Ylitalo , Brum Silveira João António , Zoni Cesar Rodrigo , Bessonov Ivan , Uccello Giuseppe , Kochiadakis George , Alexopulos Dimitrios , Uribe Carlos E. , Kanakakis John , Faurie Benjamin , Gabrielli Gabriele , Barrios Alejandro Gutierrez , Bachini Juan Pablo , Rocha Alex , Tam Frankie C. C. , Rodriguez Alfredo , Lukito Antonia Anna , Saint-Joy Veauthyelau , Pessah Gustavo , Tuccillo Andrea , Ielasi Alfonso , Cortese Giuliana , Parodi Guido , Bouraghda Mohamed Abed , Moura Marcia , Kedhi Elvin , Lamelas Pablo , Suryapranata Harry , Nardin Matteo , Verdoia Monica 
Published: January 2023

Background. Several reports have demonstrated the impact of the COVID-19 pandemic on the management and outcome of patients with ST-segment elevation myocardial infarction (STEMI). The aim of the current analysis is to investigate the potential gender difference in the effects of the COVID-19 pandemic on mechanical reperfusion and 30-day mortality for STEMI patients within the ISACS-STEMI COVID-19 Registry. Methods. This retrospective multicenter registry was performed in high-volume primary percutaneous coronary intervention (PPCI) centers on four continents and included STEMI patients undergoing PPCIs in March–June 2019 and 2020. Patients were divided according to gender. The main outcomes were the incidence and timing of the PPCI, (ischemia time ≥ 12 h and door-to-balloon ≥ 30 min) and in-hospital or 30-day mortality. Results. We included 16683 STEMI patients undergoing PPCIs in 109 centers. In 2020 during the pandemic, there was a significant reduction in PPCIs compared to 2019 (IRR 0.843 (95% CI: 0.825–0.861, p < 0.0001). We did not find a significant gender difference in the effects of the COVID-19 pandemic on the numbers of STEMI patients, which were similarly reduced from 2019 to 2020 in both groups, or in the mortality rates. Compared to prepandemia, 30-day mortality was significantly higher during the pandemic period among female (12.1% vs. 8.7%; adjusted HR [95% CI] = 1.66 [1.31–2.11], p < 0.001) but not male patients (5.8% vs. 6.7%; adjusted HR [95% CI] = 1.14 [0.96–1.34], p = 0.12). Conclusions. The COVID-19 pandemic had a significant impact on the treatment of patients with STEMI, with a 16% reduction in PPCI procedures similarly observed in both genders. Furthermore, we observed significantly increased in-hospital and 30-day mortality rates during the pandemic only among females. Trial registration number: NCT 04412655.