SCAI, ACC, ACEP Release Consensus Statement for Management of Acute Myocardial Infarction During COVID-19

Patients with cardiovascular disease who develop COVID-19 have a higher risk of mortality, according to a SCAI press release.

The Society for Cardiovascular Angiography and Interventions (SCAI), along with the American College of Cardiology and American College of Emergency Physicians, have released a consensus statement providing recommendations for a systematic approach for the care of patients with an acute myocardial infarction (AMI) during the coronavirus disease 2019 (COVID-19) pandemic.

Patients with cardiovascular disease who develop COVID-19 have a higher risk of mortality, according to a SCAI press release. However, many patients in need of care for the management of various heart diseases may not be infected with COVID-19.

The statement identifies several challenges in providing recommendations for AMI care during the COVID-19 pandemic, including cardiovascular manifestations in the COVID-19 patient being complex and variable, the availability of personal protective equipment (PPE), and the unknown prevalence of COVID-19 in US populations.

“During the COVID-19 pandemic, we wanted to ensure that patients continue to benefit from the tremendous advances made in the care of patients with cardiovascular disease over the past three decades,” said Ehtisham Mahmud, MD, FSCAI, SCAI president and lead author of the writing group in the press release. “Primary percutaneous coronary intervention (PCI) is the standard of care for STEMI patients, and in this document, we outline an approach to providing that therapy at PCI-capable hospitals while also ensuring health care worker safety with appropriate PPE.”

The study authors recommend informing the public that exposure to the virus can be minimized, including how patients can continue to call the emergency medical system when presenting with acute ischemic heart disease symptoms, with the intention of primary PCI, when indicated.

Fibrinolysis at referral hospitals (non-PCI capable) is appropriate with a plan of care for rescue or pharmacoinvasive PCI, according to the study authors. In addition, the statement provides strategies for maximizing the safety of medical personnel with appropriate use of PPE and masking patients.

REFERENCE

SCAI, ACC, and ACEP release consensus on management of AMI patients amid COVID-19 pandemic [news release]. Washington; SCAI: April 21, 2020. http://www.scai.org/Press/detail/scai-acc-acep-release-consensus-on-management-of-a#.XqHL1pNKhTY. Accessed April 23, 2020.