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CT coronary angiography and COVID-19: inpatient use in acute chest pain service

OBJECTIVES: CT coronary angiography (CTCA) is a well-validated clinical tool in the evaluation of chest pain. In our institution, CTCA availability was increased in January 2020, and subsequently, expanded further to replace all exercise testing during the COVID-19 pandemic. Our objective was to ass...

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Autores principales: Cronin, Michael, Wheen, Peter, Armstrong, Richard, Kumar, Rajesh, McMahon, Alannah, White, Max, Sheehy, Niall, McMahon, Geraldine, Murphy, Ross T, Daly, Caroline
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7976674/
https://www.ncbi.nlm.nih.gov/pubmed/33731419
http://dx.doi.org/10.1136/openhrt-2020-001548
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author Cronin, Michael
Wheen, Peter
Armstrong, Richard
Kumar, Rajesh
McMahon, Alannah
White, Max
Sheehy, Niall
McMahon, Geraldine
Murphy, Ross T
Daly, Caroline
author_facet Cronin, Michael
Wheen, Peter
Armstrong, Richard
Kumar, Rajesh
McMahon, Alannah
White, Max
Sheehy, Niall
McMahon, Geraldine
Murphy, Ross T
Daly, Caroline
author_sort Cronin, Michael
collection PubMed
description OBJECTIVES: CT coronary angiography (CTCA) is a well-validated clinical tool in the evaluation of chest pain. In our institution, CTCA availability was increased in January 2020, and subsequently, expanded further to replace all exercise testing during the COVID-19 pandemic. Our objective was to assess the impact of increased utilisation of CTCA on length of stay in patients presenting with chest pain in the prepandemic era and during the COVID-19 pandemic. METHODS: Study design was retrospective. Patients referred for cardiology review between October 2019 and May 2020 with chest pain and/or dyspnoea were broken into three cohorts: a baseline cohort, a cohort with increased CTCA availability and a cohort with increased CTCA availability, but after the national lockdown due to COVID-19. Coronary angiography and revascularisation, length of stay and 30-day adverse outcomes were assessed. RESULTS: 513 patients (35.3% female) presented over cohorts 1 (n=179), 2 (n=182), and 3 (n=153). CTCA use increased from 7.8% overall in cohort 1% to 20.4% in cohort 3. Overall length of stay for the patients undergoing CTCA decreased from a median of 4.2 days in cohort 1 to 2.5 days in cohort 3, with no increase in 30 days adverse outcomes. Invasive coronary angiogram rates were 45.8%, 39% and 34.2% across the cohorts. 29.6% underwent revascularisation in cohort 1, 15.9% in cohort 2 and to 16.4% in cohort 3. CONCLUSIONS: Increased CTCA availability was associated with a significantly reduced length of stay both pre-COVID-19 and post-COVID-19 lockdown, without any increase in 30-day adverse outcomes.
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spelling pubmed-79766742021-03-19 CT coronary angiography and COVID-19: inpatient use in acute chest pain service Cronin, Michael Wheen, Peter Armstrong, Richard Kumar, Rajesh McMahon, Alannah White, Max Sheehy, Niall McMahon, Geraldine Murphy, Ross T Daly, Caroline Open Heart Health Care Delivery, Economics and Global Health Care OBJECTIVES: CT coronary angiography (CTCA) is a well-validated clinical tool in the evaluation of chest pain. In our institution, CTCA availability was increased in January 2020, and subsequently, expanded further to replace all exercise testing during the COVID-19 pandemic. Our objective was to assess the impact of increased utilisation of CTCA on length of stay in patients presenting with chest pain in the prepandemic era and during the COVID-19 pandemic. METHODS: Study design was retrospective. Patients referred for cardiology review between October 2019 and May 2020 with chest pain and/or dyspnoea were broken into three cohorts: a baseline cohort, a cohort with increased CTCA availability and a cohort with increased CTCA availability, but after the national lockdown due to COVID-19. Coronary angiography and revascularisation, length of stay and 30-day adverse outcomes were assessed. RESULTS: 513 patients (35.3% female) presented over cohorts 1 (n=179), 2 (n=182), and 3 (n=153). CTCA use increased from 7.8% overall in cohort 1% to 20.4% in cohort 3. Overall length of stay for the patients undergoing CTCA decreased from a median of 4.2 days in cohort 1 to 2.5 days in cohort 3, with no increase in 30 days adverse outcomes. Invasive coronary angiogram rates were 45.8%, 39% and 34.2% across the cohorts. 29.6% underwent revascularisation in cohort 1, 15.9% in cohort 2 and to 16.4% in cohort 3. CONCLUSIONS: Increased CTCA availability was associated with a significantly reduced length of stay both pre-COVID-19 and post-COVID-19 lockdown, without any increase in 30-day adverse outcomes. BMJ Publishing Group 2021-03-17 /pmc/articles/PMC7976674/ /pubmed/33731419 http://dx.doi.org/10.1136/openhrt-2020-001548 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Health Care Delivery, Economics and Global Health Care
Cronin, Michael
Wheen, Peter
Armstrong, Richard
Kumar, Rajesh
McMahon, Alannah
White, Max
Sheehy, Niall
McMahon, Geraldine
Murphy, Ross T
Daly, Caroline
CT coronary angiography and COVID-19: inpatient use in acute chest pain service
title CT coronary angiography and COVID-19: inpatient use in acute chest pain service
title_full CT coronary angiography and COVID-19: inpatient use in acute chest pain service
title_fullStr CT coronary angiography and COVID-19: inpatient use in acute chest pain service
title_full_unstemmed CT coronary angiography and COVID-19: inpatient use in acute chest pain service
title_short CT coronary angiography and COVID-19: inpatient use in acute chest pain service
title_sort ct coronary angiography and covid-19: inpatient use in acute chest pain service
topic Health Care Delivery, Economics and Global Health Care
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7976674/
https://www.ncbi.nlm.nih.gov/pubmed/33731419
http://dx.doi.org/10.1136/openhrt-2020-001548
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