Poll Results: Updating CV Management in the Face of COVID-19: Decisions About a Return to Normalcy
Are we reopening? Yes, but somewhat cautiously.
In the most recent poll addressing how practices are evolving in the face of COVID-19, the overall response to the acute management of ST-segment elevation myocardial infarction (STEMI) appears to be following recent guidelines1 that emphasize use of primary percutaneous coronary intervention (PCI) and the avoidance of thrombolytics except in special circumstances. Fewer than 8% of respondents are continuing thrombolytics as the primary treatment, while just over 50% are continuing primary PCI as the standard care for STEMI, with another 10% re-adopting primary PCI. One third suggest a case-by-case decision, which may be reasonable based on many factors. But hopefully most cases are being treated by primary PCI.
Regarding the introduction of cardiovascular testing, only 15% limited introduction to noninvasive testing, while 50% included selective invasive testing. Overall, 65% favored beginning some level of testing, most commonly including selected invasive procedures. Roughly one-third still favored waiting an additional 2 weeks before resuming testing and awaiting evidence of declining rates of new infections.
Thanks to the nearly 150 respondents; as usual, all comments are appreciated.
- Mahmud E, Dauerman HL, Welt FG, et al. Management of Acute Myocardial Infarction During the COVID-19 Pandemic. J Am Coll Cardiol 2020;Apr 21:[Epub ahead of print].
Clinical Topics: COVID-19 Hub, Invasive Cardiovascular Angiography and Intervention, Noninvasive Imaging, Stable Ischemic Heart Disease, Vascular Medicine, Interventions and Imaging, Interventions and Vascular Medicine, Angiography, Nuclear Imaging, Chronic Angina
Keywords: COVID-19, ST Elevation Myocardial Infarction, Percutaneous Coronary Intervention, severe acute respiratory syndrome coronavirus 2, Anterior Wall Myocardial Infarction, Fibrinolytic Agents, Cardiovascular System, Coronavirus Infections, Infections, Angiography, Coronary Angiography
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