Effect of COVID-19 Pandemic on Acute Coronary Syndrome Clinical Practice Patterns: Findings from a Multicenter
Feng Hu1, Minhua Zang1, Lihui Zheng2
1Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 200030 Shanghai, China.
Insights
The COVID-19 pandemic significantly altered acute coronary syndrome (ACS) care. Cardiologists reported decreased use of invasive treatments and increased reliance on pharmacotherapy for ACS patients during the pandemic.
Area of Science:
- Cardiology
- Public Health
- Infectious Diseases
Background:
- The COVID-19 pandemic has significantly impacted global healthcare systems.
- Acute coronary syndrome (ACS) management is a critical area affected by the pandemic.
- Understanding these impacts is crucial for adapting cardiovascular care strategies.
Purpose of the Study:
- To investigate how cardiologists perceived the COVID-19 pandemic's effect on clinical practice patterns for acute coronary syndrome (ACS).
- To assess changes in treatment modalities for ACS during the pandemic.
- To identify challenges and adaptations in cardiovascular care during a global health crisis.
Main Methods:
- A multicenter survey was distributed to 300 cardiologists across 22 provinces in China.
- The survey collected data on cardiologist demographics and their perceptions of pandemic-related practice changes for ACS.
- A response rate of 70.3% (211 cardiologists) was achieved, with most participants from tertiary hospitals and extensive clinical experience.
Main Results:
- Most surveyed cardiologists observed a reduction in both inpatient and outpatient ACS cases during the pandemic.
- Access to dedicated catheterization facilities for COVID-19-positive ACS patients was limited (29.9%).
- Coronary interventional therapy for STEMI, NSTEMI, and unstable angina decreased significantly, while pharmacotherapy use increased. Fibrinolytic therapy for STEMI also saw increased use.
Conclusions:
- The COVID-19 pandemic has profoundly altered clinical practice patterns for acute coronary syndrome (ACS).
- A notable shift occurred from invasive treatment strategies towards increased pharmacotherapy use in ACS management.
- These findings highlight the need for flexible and adaptive approaches to cardiovascular care during public health emergencies.
Background:
The coronavirus disease 2019 (COVID-19) pandemic has severely affected healthcare systems around the world. This study aimed to investigate the perceptions of cardiologists regarding how the COVID-19 pandemic has affected the clinical practice patterns for acute coronary syndrome (ACS).
Methods:
A multicenter clinician survey was sent to 300 cardiologists working in 22 provinces in China. The survey collected demographic information and inquired about their perceptions of how the COVID-19 pandemic has affected ACS clinical practice patterns.
Results:
The survey was completed by 211 (70.3%) cardiologists, 82.5% of whom were employed in tertiary hospitals, and 52.1% reported more than 10 years of clinical cardiology practice. Most respondents observed a reduction in ACS inpatients and outpatients in their hospitals during the pandemic. Only 29.9% of the respondents had access to a dedicated catheter room for the treatment of COVID-19-positive ACS patients. Most respondents stated that the COVID-19 pandemic had varying degrees of effect on the treatment of acute ST-segment elevation myocardial infarction (STEMI), acute non-ST-segment elevation myocardial infarction (NSTEMI), and unstable angina. Compared with the assumed non-pandemic period, in the designed clinical questions, the selection of coronary interventional therapy for STEMI, NSTEMI, and unstable angina during the COVID-19 pandemic was significantly decreased (all p 0.05), and the selection of pharmacotherapy was increased (all p 0.05). The selection of fibrinolytic therapy for STEMI during the pandemic was higher than in the assumed non-pandemic period (p 0.05).
Conclusions:
The COVID-19 pandemic has profoundly affected ACS clinical practice patterns. The use of invasive therapies significantly decreased during the pandemic period, whereas pharmacotherapy was more often prescribed by the cardiologists.
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