Cargando…

Percutaneous coronary intervention during the COVID-19 pandemic in Japan: Insights from the nationwide registration data

BACKGROUND: Coronavirus disease 2019 (COVID-19) has negatively affected access to healthcare systems and treatment timelines. This study was designed to explore the impact of the COVID-19 pandemic on patients who underwent percutaneous coronary intervention (PCI). METHODS: From January 2019 to Decem...

Descripción completa

Detalles Bibliográficos
Autores principales: Yamaji, Kyohei, Kohsaka, Shun, Inohara, Taku, Numasawa, Yohei, Ando, Hirohiko, Wada, Hideki, Ishii, Hideki, Amano, Tetsuya, Miyata, Hiroaki, Ikari, Yuji
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8939342/
https://www.ncbi.nlm.nih.gov/pubmed/35330940
http://dx.doi.org/10.1016/j.lanwpc.2022.100434
_version_ 1784672711710081024
author Yamaji, Kyohei
Kohsaka, Shun
Inohara, Taku
Numasawa, Yohei
Ando, Hirohiko
Wada, Hideki
Ishii, Hideki
Amano, Tetsuya
Miyata, Hiroaki
Ikari, Yuji
author_facet Yamaji, Kyohei
Kohsaka, Shun
Inohara, Taku
Numasawa, Yohei
Ando, Hirohiko
Wada, Hideki
Ishii, Hideki
Amano, Tetsuya
Miyata, Hiroaki
Ikari, Yuji
author_sort Yamaji, Kyohei
collection PubMed
description BACKGROUND: Coronavirus disease 2019 (COVID-19) has negatively affected access to healthcare systems and treatment timelines. This study was designed to explore the impact of the COVID-19 pandemic on patients who underwent percutaneous coronary intervention (PCI). METHODS: From January 2019 to December 2020, 489,001 patients from 1068 institutions were registered in the Japanese nationwide PCI (J-PCI) registry. We constructed generalized linear models to assess the difference in the daily number of patients and in-hospital outcomes between 2019 and 2020. FINDINGS: In total, 207 institutions (19·3%) had closed or restricted access during the first COVID-19 outbreak in May 2020; the number of closed or restricted institutions had plateaued at a median of 121 institutions (11·3%). The daily case volume of PCI significantly decreased in 2020 (by 6·7% compared with that in 2019; 95% confidence interval [CI], 6·2–7·2%; p < 0·001). Marked differences in the presentation of PCI patients were observed; more patients presented with ST-segment elevation myocardial infarction (18·3% vs. 17·5%; p < 0·001), acute heart failure (4·49% vs. 4·30%; p = 0·001), cardiogenic shock (3·79% vs. 3·45%; p < 0·001), and cardiopulmonary arrest (2·12% vs. 2·00%; p = 0·002) in 2020. The excess adjusted in-hospital mortality rate in patients treated in 2020 relative to those treated in 2019 was significant (adjusted odds ratio, 1·054; 95% CI, 1·004–1·107; p = 0·03). INTERPRETATION: While the number of patients who underwent PCI substantially decreased during the COVID-19 pandemic, more patients presented with high-risk characteristics and were associated with significantly higher adjusted in-hospital mortality. FUNDING: The J-PCI registry is a registry led and supported by the Japanese Association of Cardiovascular Intervention and Therapeutics. The present study was supported by the Grant-in-Aid from the Ministry of Health and Labour (No. 20IA2002 and 21FA1015), the Grants-in-Aid for Scientific Research from the Japan Society for the Promotion of Science (KAKENHI; No. 21K08064), and the Japan Agency for Medical Research and Development (No. 17ek0210097h000).
format Online
Article
Text
id pubmed-8939342
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Elsevier
record_format MEDLINE/PubMed
spelling pubmed-89393422022-03-22 Percutaneous coronary intervention during the COVID-19 pandemic in Japan: Insights from the nationwide registration data Yamaji, Kyohei Kohsaka, Shun Inohara, Taku Numasawa, Yohei Ando, Hirohiko Wada, Hideki Ishii, Hideki Amano, Tetsuya Miyata, Hiroaki Ikari, Yuji Lancet Reg Health West Pac Articles BACKGROUND: Coronavirus disease 2019 (COVID-19) has negatively affected access to healthcare systems and treatment timelines. This study was designed to explore the impact of the COVID-19 pandemic on patients who underwent percutaneous coronary intervention (PCI). METHODS: From January 2019 to December 2020, 489,001 patients from 1068 institutions were registered in the Japanese nationwide PCI (J-PCI) registry. We constructed generalized linear models to assess the difference in the daily number of patients and in-hospital outcomes between 2019 and 2020. FINDINGS: In total, 207 institutions (19·3%) had closed or restricted access during the first COVID-19 outbreak in May 2020; the number of closed or restricted institutions had plateaued at a median of 121 institutions (11·3%). The daily case volume of PCI significantly decreased in 2020 (by 6·7% compared with that in 2019; 95% confidence interval [CI], 6·2–7·2%; p < 0·001). Marked differences in the presentation of PCI patients were observed; more patients presented with ST-segment elevation myocardial infarction (18·3% vs. 17·5%; p < 0·001), acute heart failure (4·49% vs. 4·30%; p = 0·001), cardiogenic shock (3·79% vs. 3·45%; p < 0·001), and cardiopulmonary arrest (2·12% vs. 2·00%; p = 0·002) in 2020. The excess adjusted in-hospital mortality rate in patients treated in 2020 relative to those treated in 2019 was significant (adjusted odds ratio, 1·054; 95% CI, 1·004–1·107; p = 0·03). INTERPRETATION: While the number of patients who underwent PCI substantially decreased during the COVID-19 pandemic, more patients presented with high-risk characteristics and were associated with significantly higher adjusted in-hospital mortality. FUNDING: The J-PCI registry is a registry led and supported by the Japanese Association of Cardiovascular Intervention and Therapeutics. The present study was supported by the Grant-in-Aid from the Ministry of Health and Labour (No. 20IA2002 and 21FA1015), the Grants-in-Aid for Scientific Research from the Japan Society for the Promotion of Science (KAKENHI; No. 21K08064), and the Japan Agency for Medical Research and Development (No. 17ek0210097h000). Elsevier 2022-03-22 /pmc/articles/PMC8939342/ /pubmed/35330940 http://dx.doi.org/10.1016/j.lanwpc.2022.100434 Text en © 2022 The Author(s) https://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 Articles
Yamaji, Kyohei
Kohsaka, Shun
Inohara, Taku
Numasawa, Yohei
Ando, Hirohiko
Wada, Hideki
Ishii, Hideki
Amano, Tetsuya
Miyata, Hiroaki
Ikari, Yuji
Percutaneous coronary intervention during the COVID-19 pandemic in Japan: Insights from the nationwide registration data
title Percutaneous coronary intervention during the COVID-19 pandemic in Japan: Insights from the nationwide registration data
title_full Percutaneous coronary intervention during the COVID-19 pandemic in Japan: Insights from the nationwide registration data
title_fullStr Percutaneous coronary intervention during the COVID-19 pandemic in Japan: Insights from the nationwide registration data
title_full_unstemmed Percutaneous coronary intervention during the COVID-19 pandemic in Japan: Insights from the nationwide registration data
title_short Percutaneous coronary intervention during the COVID-19 pandemic in Japan: Insights from the nationwide registration data
title_sort percutaneous coronary intervention during the covid-19 pandemic in japan: insights from the nationwide registration data
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8939342/
https://www.ncbi.nlm.nih.gov/pubmed/35330940
http://dx.doi.org/10.1016/j.lanwpc.2022.100434
work_keys_str_mv AT yamajikyohei percutaneouscoronaryinterventionduringthecovid19pandemicinjapaninsightsfromthenationwideregistrationdata
AT kohsakashun percutaneouscoronaryinterventionduringthecovid19pandemicinjapaninsightsfromthenationwideregistrationdata
AT inoharataku percutaneouscoronaryinterventionduringthecovid19pandemicinjapaninsightsfromthenationwideregistrationdata
AT numasawayohei percutaneouscoronaryinterventionduringthecovid19pandemicinjapaninsightsfromthenationwideregistrationdata
AT andohirohiko percutaneouscoronaryinterventionduringthecovid19pandemicinjapaninsightsfromthenationwideregistrationdata
AT wadahideki percutaneouscoronaryinterventionduringthecovid19pandemicinjapaninsightsfromthenationwideregistrationdata
AT ishiihideki percutaneouscoronaryinterventionduringthecovid19pandemicinjapaninsightsfromthenationwideregistrationdata
AT amanotetsuya percutaneouscoronaryinterventionduringthecovid19pandemicinjapaninsightsfromthenationwideregistrationdata
AT miyatahiroaki percutaneouscoronaryinterventionduringthecovid19pandemicinjapaninsightsfromthenationwideregistrationdata
AT ikariyuji percutaneouscoronaryinterventionduringthecovid19pandemicinjapaninsightsfromthenationwideregistrationdata
AT percutaneouscoronaryinterventionduringthecovid19pandemicinjapaninsightsfromthenationwideregistrationdata