Trends in Major Adverse Cardiac Events and Healthcare Resource Utilization During the COVID-19 Pandemic in Alberta, Canada

BACKGROUND: Atherosclerotic cardiovascular disease (ASCVD) is a leading cause of morbidity and mortality in Canada. The COVID-19 pandemic altered the usual care of ambulatory and acute cardiac patients. This study aimed to describe ASCVD-related clinical outcomes and healthcare resource utilization (HCRU) patterns during the COVID-19 pandemic in Alberta, Canada, relative to the 3 preceding years. METHODS: A study with a repeated cross-sectional design was conducted over 3-month periods, using administrative health data from between March 15, 2017 and March 14, 2021. ASCVD-related clinical outcomes included major adverse cardiovascular event endpoints. HCRU was assessed through general practitioner and other healthcare professional visits (including telehealth claims) for ASCVD events, emergency department visits, ASCVD diagnostic imaging tests, laboratory tests, and hospital length of stay. RESULTS: Relative to the control year period (March to June 2019), ASCVD-related events (ie, hospitalizations, emergency department visits, and physician office visits) declined by 23% during the 3-month COVID-19 period (March to June, 2020). Acute declines were not sustained following June 2020. In contrast, in-patient mortality rates involving a primary major adverse cardiovascular event endpoint increased from March to June 2020 of the COVID-19 period. CONCLUSIONS: This study demonstrates that the COVID-19 pandemic and corresponding public health restrictions impacted ASCVD-related care. Although many clinical outcomes returned to pre-pandemic levels at the end of the observation period, our results suggest that HCRU by patients declined, which could lead to further cardiovascular events and mortality. Understanding the impact of COVID-19 restrictions on ASCVD-related care may help improve healthcare resiliency.