Cargando…

COVID-19 and changes in activity and treatment of ST elevation MI from a UK cardiac centre

BACKGROUND: The international healthcare response to COVID-19 has been driven by epidemiological data related to case numbers and case fatality rate. Second order effects have been less well studied. This study aimed to characterise the changes in emergency activity of a high-volume cardiac catheter...

Descripción completa

Detalles Bibliográficos
Autores principales: Chen, Yang, Rathod, Krishnaraj S., Hamshere, Stephen, Choudry, Fizzah, Akhtar, Mohammed M., Curtis, Miles, Amersey, Rajiv, Guttmann, Oliver, O'Mahony, Constantinos, Jain, Ajay, Wragg, Andrew, Baumbach, Andreas, Mathur, Anthony, Jones, Daniel A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7901371/
https://www.ncbi.nlm.nih.gov/pubmed/33644297
http://dx.doi.org/10.1016/j.ijcha.2021.100736
_version_ 1783654375820886016
author Chen, Yang
Rathod, Krishnaraj S.
Hamshere, Stephen
Choudry, Fizzah
Akhtar, Mohammed M.
Curtis, Miles
Amersey, Rajiv
Guttmann, Oliver
O'Mahony, Constantinos
Jain, Ajay
Wragg, Andrew
Baumbach, Andreas
Mathur, Anthony
Jones, Daniel A.
author_facet Chen, Yang
Rathod, Krishnaraj S.
Hamshere, Stephen
Choudry, Fizzah
Akhtar, Mohammed M.
Curtis, Miles
Amersey, Rajiv
Guttmann, Oliver
O'Mahony, Constantinos
Jain, Ajay
Wragg, Andrew
Baumbach, Andreas
Mathur, Anthony
Jones, Daniel A.
author_sort Chen, Yang
collection PubMed
description BACKGROUND: The international healthcare response to COVID-19 has been driven by epidemiological data related to case numbers and case fatality rate. Second order effects have been less well studied. This study aimed to characterise the changes in emergency activity of a high-volume cardiac catheterisation centre and to cautiously model any excess indirect morbidity and mortality. METHOD: Retrospective cohort study of patients admitted with acute coronary syndrome fulfilling criteria for the heart attack centre (HAC) pathway at St. Bartholomew’s hospital, UK. Electronic data were collected for the study period March 16th – May 16th 2020 inclusive and stored on a dedicated research server. Standard governance procedures were observed in line with the British Cardiovascular Intervention Society audit. RESULTS: There was a 28% fall in the number of primary percutaneous coronary interventions (PCIs) for ST elevation myocardial infarction (STEMI) during the study period (111 vs. 154) and 36% fewer activations of the HAC pathway (312 vs. 485), compared to the same time period averaged across three preceding years. In the context of ‘missing STEMIs’, the excess harm attributable to COVID-19 could result in an absolute increase of 1.3% in mortality, 1.9% in nonfatal MI and 4.5% in recurrent ischemia. CONCLUSIONS: The emergency activity of a high-volume PCI centre was significantly reduced for STEMI during the peak of the first wave of COVID-19. Our data can be used as an exemplar to help future modelling within cardiovascular workstreams to refine aggregate estimates of the impact of COVID-19 and inform targeted policy action.
format Online
Article
Text
id pubmed-7901371
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Elsevier
record_format MEDLINE/PubMed
spelling pubmed-79013712021-02-24 COVID-19 and changes in activity and treatment of ST elevation MI from a UK cardiac centre Chen, Yang Rathod, Krishnaraj S. Hamshere, Stephen Choudry, Fizzah Akhtar, Mohammed M. Curtis, Miles Amersey, Rajiv Guttmann, Oliver O'Mahony, Constantinos Jain, Ajay Wragg, Andrew Baumbach, Andreas Mathur, Anthony Jones, Daniel A. Int J Cardiol Heart Vasc Original Paper BACKGROUND: The international healthcare response to COVID-19 has been driven by epidemiological data related to case numbers and case fatality rate. Second order effects have been less well studied. This study aimed to characterise the changes in emergency activity of a high-volume cardiac catheterisation centre and to cautiously model any excess indirect morbidity and mortality. METHOD: Retrospective cohort study of patients admitted with acute coronary syndrome fulfilling criteria for the heart attack centre (HAC) pathway at St. Bartholomew’s hospital, UK. Electronic data were collected for the study period March 16th – May 16th 2020 inclusive and stored on a dedicated research server. Standard governance procedures were observed in line with the British Cardiovascular Intervention Society audit. RESULTS: There was a 28% fall in the number of primary percutaneous coronary interventions (PCIs) for ST elevation myocardial infarction (STEMI) during the study period (111 vs. 154) and 36% fewer activations of the HAC pathway (312 vs. 485), compared to the same time period averaged across three preceding years. In the context of ‘missing STEMIs’, the excess harm attributable to COVID-19 could result in an absolute increase of 1.3% in mortality, 1.9% in nonfatal MI and 4.5% in recurrent ischemia. CONCLUSIONS: The emergency activity of a high-volume PCI centre was significantly reduced for STEMI during the peak of the first wave of COVID-19. Our data can be used as an exemplar to help future modelling within cardiovascular workstreams to refine aggregate estimates of the impact of COVID-19 and inform targeted policy action. Elsevier 2021-02-23 /pmc/articles/PMC7901371/ /pubmed/33644297 http://dx.doi.org/10.1016/j.ijcha.2021.100736 Text en © 2021 Published by Elsevier B.V. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Paper
Chen, Yang
Rathod, Krishnaraj S.
Hamshere, Stephen
Choudry, Fizzah
Akhtar, Mohammed M.
Curtis, Miles
Amersey, Rajiv
Guttmann, Oliver
O'Mahony, Constantinos
Jain, Ajay
Wragg, Andrew
Baumbach, Andreas
Mathur, Anthony
Jones, Daniel A.
COVID-19 and changes in activity and treatment of ST elevation MI from a UK cardiac centre
title COVID-19 and changes in activity and treatment of ST elevation MI from a UK cardiac centre
title_full COVID-19 and changes in activity and treatment of ST elevation MI from a UK cardiac centre
title_fullStr COVID-19 and changes in activity and treatment of ST elevation MI from a UK cardiac centre
title_full_unstemmed COVID-19 and changes in activity and treatment of ST elevation MI from a UK cardiac centre
title_short COVID-19 and changes in activity and treatment of ST elevation MI from a UK cardiac centre
title_sort covid-19 and changes in activity and treatment of st elevation mi from a uk cardiac centre
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7901371/
https://www.ncbi.nlm.nih.gov/pubmed/33644297
http://dx.doi.org/10.1016/j.ijcha.2021.100736
work_keys_str_mv AT chenyang covid19andchangesinactivityandtreatmentofstelevationmifromaukcardiaccentre
AT rathodkrishnarajs covid19andchangesinactivityandtreatmentofstelevationmifromaukcardiaccentre
AT hamsherestephen covid19andchangesinactivityandtreatmentofstelevationmifromaukcardiaccentre
AT choudryfizzah covid19andchangesinactivityandtreatmentofstelevationmifromaukcardiaccentre
AT akhtarmohammedm covid19andchangesinactivityandtreatmentofstelevationmifromaukcardiaccentre
AT curtismiles covid19andchangesinactivityandtreatmentofstelevationmifromaukcardiaccentre
AT amerseyrajiv covid19andchangesinactivityandtreatmentofstelevationmifromaukcardiaccentre
AT guttmannoliver covid19andchangesinactivityandtreatmentofstelevationmifromaukcardiaccentre
AT omahonyconstantinos covid19andchangesinactivityandtreatmentofstelevationmifromaukcardiaccentre
AT jainajay covid19andchangesinactivityandtreatmentofstelevationmifromaukcardiaccentre
AT wraggandrew covid19andchangesinactivityandtreatmentofstelevationmifromaukcardiaccentre
AT baumbachandreas covid19andchangesinactivityandtreatmentofstelevationmifromaukcardiaccentre
AT mathuranthony covid19andchangesinactivityandtreatmentofstelevationmifromaukcardiaccentre
AT jonesdaniela covid19andchangesinactivityandtreatmentofstelevationmifromaukcardiaccentre