Impact of COVID-19 on door-to-wire time in ST-segment elevation myocardial infarction treatment: the role of digital communication.

Introduction: ST-segment elevation myocardial infarction (STEMI) is a life-threatening cardiovascular emergency necessitating rapid reperfusion. During the COVID-19 pandemic, healthcare providers faced the challenge of ensuring timely STEMI interventions while managing the risk of viral transmission in hospitals. This study aims to analyze changes in the door-to-wire (D-to-W) time for STEMI treatment across three pandemic phases-early pre-epidemic phase (Group C), initial lockdown phase (Group A), and intermediate normalization phase (Group B). It also examines the impact of digital communication tools, collectively referred to as "InterNet" (e.g., Twitter, WeChat), on treatment processes.

Methods: Based on data of 630 STEMI patients treated in Chest Pain Center in a particular hospital in China from 2019 to 2020, changes in D-to-W time in different groups are measured. Time intervals in STEMI treatment process are also predicted by Bayesian statistics approach. The study investigated the influence of InterNet utilization before and after the pandemic through a questionnaire-based assessment.

Results: For transfer-non-emergency- treatment, the time from first-electrocardiogram to preliminary-diagnosis in Group-A is significantly longer than that in Groups-B and -C (p = 0.004, p = 0.004); the time from decision-on-intervention to catheterization-room-activation in Group-A and -B is significantly longer than that in Group-C (p = 0.003, p < 0.001). For transfer-emergency- treatment, the time from first-medical-contact to arterial-puncture in Group-A and -B is remarkably shorter than that in Group-C (p = 0.006). Meanwhile, Bayesian method performs well in forecasting time intervals, so it can provide effective assistance for STEMI treatment. The findings from the questionnaire indicated that physicians perceived a significant association between the optimal management of STEMI and an increased frequency of InterNet tool usage following the pandemic (p = 0.019).

Conclusions: The treatment and management of STEMI patients have been in dilemmas and various time intervals of D-to-W are inevitably prolonged during the COVID-19 pandemic. The implementation of InterNet tools proved essential for minimizing delays in D-to-W and FMC-to-W times, offering a valuable strategy for enhancing STEMI care amid ongoing pandemic challenges.

Clinical Trial Number: Not applicable.