ABSTRACT
Introduction and objectives: During the lockdown due to the pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a decrease in the number of admissions due to acute coronary syndrome (ACS) was observed. The objective of our study was to evaluate the impact lockdown had on the incidence, morbidity and mortality, and management of ACS. Methods: A retrospective and multicenter study was conducted including patients admitted due to ACS from February 14 through June 24, 2020. Patients with acute myocardial infarction and coronary arteries without significant lesions were excluded. The following groups were established based on the period of admission: a) 1 month before lockdown;b) during lockdown;and c) 1 month after lockdown. The differences in mortality seen among the 3 groups were evaluated, as well as the temporal differences reported between symptom onset and the first medical contact (FMC). Results: a total of 634 patients were included (group a, 205;group b, 303, and group c, 126). A 41% decrease in the number of admissions due to ACS was observed during the first month of lockdown compared to the previous month, as well as diagnostic delay during this same period (group a, 66 minutes (45-180), group b, 120 minutes (60-240), and group c, 120 minutes (60-240), P =.007). However, a higher mortality rate during confinement was not reported (RR, 1.26;95%CI, 0.53-2.97;P =.60). Conclusions: During lockdown, a remarkable decrease in the number of admissions due to ACS was observed, and although there was an increase in the time elapsed from symptom onset to the FCM in this period in patients with STEMI, the mortality rate was similar in the 3 groups studied.
ABSTRACT
Introduction and objectives: The Interventional Cardiology Association of the Spanish Society of Cardiology (ACI-SEC) presents its annual activity report for 2021. Methods: All Spanish centers with catheterization laboratories were invited to participate. Data were collected online and were analyzed by an external company, together with the members of the ACI-SEC. Results: A total of 121 centers participated (83 public and 38 private). Compared to 2020, both diagnostic coronary angiograms and percutaneous coronary interventions (PCI) increased by 11,4% and 10,3%, respectively. The radial approach was the most used access (92,8%). Primary PCI also increased by 6.2% whereas rescue PCI (1,8%) and facilitated PCI (2,4%) were less frequently conducted. Transcatheter aortic valve implantation was one of the interventions with the most relevant increase. A total of 5720 transcatheter aortic valve implantation procedures were conducted with an increase of 34,9% compared to 2020 (120 per million in 2021 and 89,4 per million in 2020). Other structural interventions like transcatheter mitral or tricuspid repair, left atrial appendage occlusion and patent foramen oval closure also experienced a significant increase. Conclusions: The 2021 registry demonstrates a clear recovery of the activity both in coronary and structural interventions showing a relevant increase compared to 2020, the year of the COVID-19 pandemic.
ABSTRACT
The current COVID-19 outbreak is forcing healthcare workers to continuously reconsider the proper indications for cardiac catheterization. Human and material resources optimization, infection prevention for patients and healthcare workers, and transfer times force a rethink of the previously established protocols. This article is a consensus statement of the Interventional Cardiology Association and the Ischemic Heart Disease Association of the Spanish Society of Cardiology and aims to provide information to healthcare workers on the indications of diagnostic or therapeutic cardiac catheterization during the current COVID-19 pandemic. © 2019 Permanyer Publications. All rights reserved.
ABSTRACT
This article reviews the most relevant studies in the field of interventional cardiology in 2020. In the area of coronary intervention, relevant information with respect to the percutaneous coronary intervention (PCI) vs coronary artery bypass grafting for the left main treatment has been published, as well as, the best approach in dealing with complex bifurcation lesions. There have also been significant studies regarding antiplatelet strategies in patients with acute coronary syndrome undergoing PCI, which will potentially change our clinical practice. Regarding stable angina, data point out that an initial conservative treatment can be an appropriate strategy. Finally, coronary physiology continues to generate a great interest in different clinical and anatomical contexts. The advances in the field of intervention for structural heart disease have continued to increase exponentially in the last year. The first randomized trial assessing the optimal antithrombotic treatment after transcatheter aortic valve implantation has been published and that will have clinical implications. It also highlightes the development and implantation of the first mitral and tricuspid percutaneous prosthesis, as well as, the evidence in favour of left atrial appendage closure in high-risk patients. Finally, this year has been marked by the COVID-19 pandemic which has had an impact on the clinical and research activities.