The Impact of the COVID-19 Pandemic and the Importance of Telemedicine in Managing Acute ST Segment Elevation Myocardial Infarction Patients: Preliminary Experience and Literature Review

Jiang, Nan; Jia, Ruofei; Meng, Shuai; Jin, Yu-Bo; Chen, Wei; Hu, Hongyu

doi:10.1007/s10916-020-01703-6

Cited by 24 publications

(21 citation statements)

References 74 publications

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“…Telemedicine has a potentially broad application to cardiovascular disease (CVD), and it might have an important role as part of a strategy for the delivery of effective healthcare for patients with CVD, especially those with MI that is considered a leading cause of mortality and morbidity ( 7 ). Many studies showed that telemedicine is widely used in the cardiovascular field, such as in remote blood pressure (BP) monitoring ( 8 ), pre-hospital electrocardiography in the management of MI ( 9 ), monitoring of arrhythmias ( 7 ), monitoring of anticoagulant therapy ( 10 ), and regular follow-up of chronic cardiac conditions such as in heart failure and following MI or PCI, especially following the coronavirus disease 19 (COVID-19) pandemic ( 11 , 12 ).…”

Section: Introductionmentioning

confidence: 99%

Telemedicine Improves the Short-Term Medical Care of Acute ST-Segment Elevation Myocardial Infarction After Primary Percutaneous Coronary Intervention

Kamel

Hafez

Bastawy

2021

Front. Cardiovasc. Med.

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Objectives: Telemedicine appears to be a promising tool for healthcare professionals to deliver remote care to patients with cardiovascular diseases especially during the COVID-19 pandemic. We aimed in this study to evaluate the value of telemedicine added to the short-term medical care of acute ST-segment elevation myocardial infarction (STEMI) after primary percutaneous coronary intervention (PCI).Methods: Two hundred acute STEMI patients after primary PCI were randomly divided into two groups. One hundred patients in group A (study group) received a monthly videoconferencing teleconsultation using a smartphone application for 3 months starting 1 week after discharge and at least a single face-to-face (F2F) clinic visit. We reviewed in each virtual visit the symptoms of patients, adherence to healthy lifestyle measures, medications, smoking cessation, and cardiac rehabilitation. Group B (control group) included 100 patients who received at least a single F2F clinic visit in the first 3 months after discharge. Both groups were interviewed after 4 months from discharge for major adverse cardiac events (MACE), adherence to medications, smoking cessation, and cardiac rehabilitation. A survey was done to measure the satisfaction of patients with telemedicine.Results: There was no significant difference between both groups in MACE and their adherence to aspirin, P2Y12 inhibitor, and beta-blockers. However, group A patients had better adherence to statins, angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, smoking cessation, and cardiac rehabilitation. Sixty-one percent of patients stated that these videoconferencing teleconsultations were as good as the clinic visits, while 87% of patients were satisfied with telemedicine.Conclusions: Telemedicine may provide additional benefit to the short-term regular care after primary PCI to STEMI patients through videoconferencing teleconsultations by increasing their adherence to medications and healthy lifestyle measures without a significant difference in the short-term MACE. These virtual visits gained a high level of satisfaction among the patients.

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Section: Introductionmentioning

confidence: 99%

Telemedicine Improves the Short-Term Medical Care of Acute ST-Segment Elevation Myocardial Infarction After Primary Percutaneous Coronary Intervention

Kamel

Hafez

Bastawy

2021

Front. Cardiovasc. Med.

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“…Management of patients with ST-segment elevation myocardial infarction (STEMI) amid COVID-19 was controversial at first, with some advocating for fibrinolytics to mitigate delays and protect healthcare workers 9 . However, it was soon realized that some of these patients have no culprit vessel on angiography, and it was found that this treatment strategy increased mortality 10 . Given these concerning findings, guidelines reinforced primary PCI as the standard of care for STEMI and non-ST-elevation myocardial infarction (NSTEMI) in patients with high-risk features 11 , 12 .…”

Section: Introductionmentioning

confidence: 99%

Evolution of Management and Outcomes of Patients with Myocardial Injury During the COVID-19 Pandemic

Case

Abramowitz

Shea

et al. 2021

The American Journal of Cardiology

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Cardiac involvement in coronavirus disease 2019 (COVID-19) has been established. This is manifested by troponin elevation and associated with worse patient prognosis. We evaluated whether patient outcomes improved as experience accumulated during the pandemic. We analyzed COVID-19-positive patients with myocardial injury (defined as troponin elevation) who presented to the MedStar Health system (11 hospitals in Washington, DC, and Maryland) during the “Early Phase” of the pandemic (March 1 – June 30, 2020) and compared their characteristics and outcomes to the COVID-19-positive patients with the presence of troponin elevation in the “Later Phase” of the pandemic (October 1, 2020 – January 31, 2021). The cohort included 788 COVID-19-positive admitted patients for whom troponin was elevated, 167 during the “Early Phase” and 621 during the “Later Phase.” Maximum troponin-I in the “Early Phase” was 13.46±34.72 ng/mL versus 11.21±20.57 ng/mL in the “Later Phase” (p = 0.553). In-hospital mortality was significantly higher in the “Later Phase” (50.3% vs. 24.6%; p<0.001), as were incidence of intensive-care-unit admission (77.8% vs. 46.1%; p<0.001) and need for mechanical ventilation (61.7% versus 28%; p<0.001). In addition, more “Early Phase” patients underwent coronary angiography (6% vs. 2.3%; p=0.013). Finally, 3% of “Early Phase” and 0.8% of “Later Phase” patients underwent percutaneous coronary intervention (p=0.025). In conclusion, treatment outcomes have significantly improved since the beginning of the pandemic in COVID-19-positive patients with troponin elevation. This may be attributed to awareness, severity of the disease, improvements in therapies, and provider experience.

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“…Telemedicine is also used to evaluate the diagnosis and treatment of patients after discharge when social distancing is required. As a result, the admission rate in hospitals decreases (Nan et al 2021 ). Critical diagnostic and monitoring of remote patients are other aspects of telemedicine that involve smartphone, Bluetooth, and global positioning system technologies.…”

Section: Discussionmentioning

confidence: 99%

Emerging technologies and their roles during the COVID-19 pandemic and safety challenges of frontline medical staff: a rapid review

et al. 2021

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Purpose The coronavirus 2019 (COVID-19) pandemic has rapidly spread worldwide, with an ever-increasing number of confirmed positive cases and mortality rate. Moreover, frontline medical staff fighting with the COVID-19 infection have been infected and show psychological effects of the pandemic. This study presents an overview of the emerging literature on the safety challenges of frontline medical staff and how technology is being used to control the COVID-19 pandemic. Methods This study conducts a rapid review of available studies by following the “preferred reporting items for systematic reviews and meta-analyses” (PRISMA) guidelines. Sixty-three articles were selected for this rapid review paper from three popular digital data repositories. Results The majority of the studies chosen focused on the discussion of COVID-19 with regard to China, Singapore, Italy, and the USA. A previously proposed framework is used to synthesize the findings of this study. The results throw light on the several challenges faced by medical staff during the COVID-19 pandemic. Eleven major technologies have been identified in this paper. Conclusion This work concludes that technology helps in the prevention and detection of the COVID-19 infection, where it specifically helps in reducing the safety challenges of frontline medical staff and monitoring the COVID-19 patients.

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The Impact of the COVID-19 Pandemic and the Importance of Telemedicine in Managing Acute ST Segment Elevation Myocardial Infarction Patients: Preliminary Experience and Literature Review

Cited by 24 publications

References 74 publications

Telemedicine Improves the Short-Term Medical Care of Acute ST-Segment Elevation Myocardial Infarction After Primary Percutaneous Coronary Intervention

Telemedicine Improves the Short-Term Medical Care of Acute ST-Segment Elevation Myocardial Infarction After Primary Percutaneous Coronary Intervention

Evolution of Management and Outcomes of Patients with Myocardial Injury During the COVID-19 Pandemic

Emerging technologies and their roles during the COVID-19 pandemic and safety challenges of frontline medical staff: a rapid review

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