Cardiac Catheterization, Coronary Angiography (CA) and Percutaneous Coronary Intervention (PCI) in Austria during the Year 2020 (including AUDIT 2021)

Using methods on cardiac catheterization from ANCALAR complete data from reporting year 2020 are now available. The rate of diagnostic coronary angiography procedures (CAG;-8,7%), total acute plus non-acute PCI (-9.9%), including non-acute PCI (-9.5%), interventions for acute PCI (-10.6%) and including STEMI-PCI (-6.8%) declined during the pandemic year 2020 for the first time compared to the years before. Moreover left ventricular angiography (-12.2%), right heart catheterization (-17.3%), myocardial biopsies (-42.5%), PCI for chronic total occlusions (CTO;-14.1%), clot catcher (-10.3%), and rotablator procedures (-6.7%), as well as electrophysiologic diagnostics (-8.3%) und therapies (ablations;-6.9%) decreased in 2020 compared to 2019 in 27 Austrian Catheterization Laboratories. It is possible that patients suffering from acute, subacute or chronic symptoms presented less frequently in tertiary centres. Private Institutions rather increased the rate of elective procedures during the pandemic year 2020 (elective non acute PCI +9.7%) in contrast to the Austrian trend. Private Institutions but decreased the rate of acute PCI (-40,5%) on a basis of low numbers in pre-existing procedures. On the other hand in non-private Institutions in five centres there was an increase in STEMI-PCI by 23% in contrast to the Austrian decreasing trend. Possibly due to limited access to surgical intensive care wards during the pandemic, percutaneous aortic valve implantations (TAVI;+4.3%), percutaneous Mitral-Clipping (+28%) and defect closure procedures (+2.2%) within Cathlabs increased in 2020 within the whole country, compared to all the years before. This new trend in cardiac procedures within catheterization laboratories was not expected fora whole year and is now documented for Austria correlating to results in the Swedish Coronary Angiography and Angioplasty Registry (SCAAR). The presentation is also available at http://iik.i-med.ac.at.

Data on Cardiac Catheterization during the COVID Pandemic-Year 2020 in Relation to Year 2019 (Austrian ANCALAR-Registry)

Using methods on cardiac catheterization from ANCALAR we compared data from year 2020 to data from 2019 and previous years by conducting a late breaking survey. 12 centres voluntarily provided data for comparative analyses. During the COVID-19 pandemic in 2020 cardiac catheterization procedures decreased markedly and for the first time. The rate of diagnostic coronary angiographic procedures (CAG) declined by -8.2 % (p < 0.001), total acute plus non-acute PCI by -10.0 % (p < 0.001), interventions for acute PCI declined by -12.5 % (p < 0.001) and STEMI-PCI declined by -2.0 % (p = 0.6). Data scattering concerning urban or rural areas, concerning private or public institutions was present but not causative. Moreover left ventricular angiography, right heart catheterization, myocardial biopsies, PCI for chronic total occlusions (CTO), clot catcher, and rotablator procedures, as well as electrophysiologic dia-gnostics und therapies (ablations) decreased. On the other hand percutaneous aortic valve implantation (TAVI), Mitral-Clipping and defect closures within CathLabs increased in 2020. It is possible that patients suffering from acute or subacute symptoms presented less frequently in tertiary centres or that pandemic-related delays for elective procedures have led to later presentations as acute coronary syndromes. This trend of mostly declining cardiac procedures in catheterization laboratories for the whole year was not expected and studies on details and on future clinical impact are warranted.

Comparing Outcome of Cardiac Catheterization in March 2020 with March 2019

Using methods on cardiac catheterization from ANCALAR we compared data from March 2020 to data from March 2019 by conducting a "snapshot"-survey. 11 centres voluntarily provided data for comparative analyses. During the COVID-19 pandemic in 2020 cardiac catheterisation procedures markedly decreased. The rate of diagnostic angiographic procedures declined by 26%, non-acute PCI by 29%, and interventions for acute coronary syndromes by 14% [(STEMI-PCI (-18%) and NSTEMI-PCI (-15%)]. As expected, this trend of declining cardiac procedures in catheterisation laboratories may influence outcomes and further decision making. Further studies are warranted to confirm this trend and future clinical impact.