Decrease in cardiac catheterization and MI during COVID pandemic
A Ullah1, D G W Fraser1,2, F Fath-Ordoubadi1
1Manchester Heart Centre, Purple Zone 1st Floor, Manchester Foundation Trust, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL, UK.
Insights
The COVID-19 pandemic caused a 48.5% reduction in cardiac catheterizations at a UK hospital. This decrease in procedures, including for myocardial infarction (MI), raises concerns about patient outcomes and service restoration.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- The COVID-19 pandemic has led to significant disruptions in routine hospital services.
- Cardiac procedures, including those for myocardial infarction (MI), have seen widespread reductions in hospital admissions.
Purpose of the Study:
- To analyze the impact of the COVID-19 pandemic lockdown on cardiac catheterization procedures.
- To compare the volume of coronary catheterizations during the peak pandemic period with the previous year.
Main Methods:
- A retrospective review of coronary catheterization procedures and MI admissions was conducted.
- Data from a 10-week period during the 2020 COVID-19 lockdown was compared to the same period in 2019.
Main Results:
- There was a 48.4% drop in all coronary catheterizations, with 278 procedures in 2020 compared to 539 in 2019.
- STEMI (ST-elevation myocardial infarction) cases decreased by 29%, NSTEMI (non-ST-elevation myocardial infarction) by 38.9%, and elective procedures by 83%.
Conclusions:
- A significant 48.5% reduction in coronary catheterizations occurred during the peak COVID-19 pandemic in a tertiary English hospital.
- These findings align with international reports and underscore the potential adverse patient consequences of delayed MI presentation and challenges in service recovery post-pandemic.
Abstract:
The consequences of severe acute viral respiratory syndrome (COVID 19) pandemic include collateral effects, one of which has been the significant reduction in routine hospital work. With widespread reports indicating reduction of cardiac procedures including MI presentation to hospitals, we aimed to analyze the local data over a 10-week period during lockdown in a tertiary cardiac centre Catheter Laboratory in England.
Methods:
We conducted a retrospective review of the coronary catheterisation procedures and admissions with MI over the peak COVID-19 pandemic 10-week period (23rd March-30th May) in 2020, compared with the same 10-week period (25th March-2nd June) in 2019.
Results:
In 2019, 539 patients were admitted to the Cath lab for coronary catheterisation (M = 385:F = 154; mean age 65 years; STEMI = 186, NSTEMI = 192, elective = 161). In 2020, during peak period of COVID19 pandemic in England, a total of 278 patients were admitted for coronary catheterisation over the 10-week period (M = 201:F = 77; mean age 60.5 years; STEMI = 132, NSTEMI = 118, elective = 28). During peak COVID19 pandemic, this represents a 48.4% drop in all coronary catheterisations. The reduction in STEMI was 29% (54 less), in NSTEMI was 38.9% (74 less) and elective procedures dropped by 83% (133 less).
Conclusion:
During peak COVID hospital admission period in England, we report a 48.5% reduction in coronary catheterisation in our tertiary hospital. These results are consistent with reports from other countries, and highlight the worrying potential consequences for these patients arising from delays in presentation with MI, and the challenges for restoring services post-pandemic.
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