EAPCI position statement on invasive management of acute coronary syndromes during the COVID-19 pandemic: European Heart Journal

A. Chieffo, G.G. Stefanini, S. Price, E. Barbato, G. Tarantini, N. Karam, R. Moreno, G.L. Buchanan, M. Gilard, S. Halvorsen, K. Huber, S. James, F.-J. Neumann, H. Möllmann, M. Roffi, G. Tavazzi, J.M. Ferré, S. Windecker, D. Dudek, A. Baumbach

Research output: Contribution to journalArticlepeer-review


The coronavirus disease 2019 (COVID-19) pandemic poses an unprecedented challenge to healthcare worldwide. The infection can be life threatening and require intensive care treatment. The transmission of the disease poses a risk to both patients and healthcare workers. The number of patients requiring hospital admission and intensive care may overwhelm health systems and negatively affect standard care for patients presenting with conditions needing emergency interventions. This position statements aims to assist cardiologists in the invasive management of acute coronary syndrome (ACS) patients in the context of the COVID-19 pandemic. To that end, we assembled a panel of interventional cardiologists and acute cardiac care specialists appointed by the European Association of Percutaneous Cardiovascular Interventions (EAPCI) and from the Acute Cardiovascular Care Association (ACVC) and included the experience from the first and worst affected areas in Europe. Modified diagnostic and treatment algorithms are proposed to adapt evidence-based protocols for this unprecedented challenge. Various clinical scenarios, as well as management algorithms for patients with a diagnosed or suspected COVID-19 infection, presenting with ST- and non-ST-segment elevation ACS are described. In addition, we address the need for re-organization of ACS networks, with redistribution of hub and spoke hospitals, as well as for in-hospital reorganization of emergency rooms and cardiac units, with examples coming from multiple European countries. Furthermore, we provide a guidance to reorganization of catheterization laboratories and, importantly, measures for protection of healthcare providers involved with invasive procedures. © 2020 European Society of Cardiology.
Original languageEnglish
Pages (from-to)1839-1851
Number of pages13
JournalEur. Heart J.
Issue number19
Publication statusPublished - 2020


  • ACS
  • COVID-19
  • PCI
  • biological marker
  • troponin
  • acute coronary syndrome
  • Article
  • blood clot lysis
  • cardiogenic shock
  • cardiovascular risk
  • clinical feature
  • conservative treatment
  • coronary angiography
  • coronavirus disease 2019
  • disease association
  • disease burden
  • emergency care
  • evidence based medicine
  • extracorporeal oxygenation
  • heart infarction
  • heart muscle injury
  • high risk patient
  • human
  • invasive procedure
  • low risk patient
  • non st segment elevation acute coronary syndrome
  • pandemic
  • priority journal
  • prognosis
  • revascularization
  • ST segment elevation myocardial infarction
  • cardiology
  • Coronavirus infection
  • infection control
  • non ST segment elevation myocardial infarction
  • practice guideline
  • procedures
  • virology
  • virus pneumonia
  • Acute Coronary Syndrome
  • Cardiology
  • Coronavirus Infections
  • Humans
  • Infection Control
  • Non-ST Elevated Myocardial Infarction
  • Pandemics
  • Pneumonia, Viral
  • ST Elevation Myocardial Infarction


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