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1.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-317393

ABSTRACT

Background: During COVID-19 pandemic, elective invasive cardiac procedures (ICP) have been frequently cancelled or postponed. Consequences may be more evident in patients with diabetes. Objectives: The objective was to identify the peculiarities of patients with DM among those in whom ICP were cancelled or postponed due to the COVID-19 pandemic, as well as to identify subgroups in which the influence of DM has higher impact on the clinical outcome. Methods: : We included 2,158 patients in whom an elective ICP was cancelled or postponed during COVID-19 pandemic in 37 hospitals in Spain. Among them, 700 (32.4%) were diabetics. Patients with and without diabetes were compared. Results: : Patients with diabetes were older and had a higher prevalence of other cardiovascular risk factors, previous cardiovascular history and co-morbidities. Diabetics had a higher mortality (3.0% vs. 1.0%;p=0.001) and cardiovascular mortality (1.9% vs. 0.4%;p=0.001). Differences were especially important in patients with valvular heart disease (mortality 6.9% vs 1.7% [p<0.001] and cardiovascular mortality 4.9% vs 0.9% [p=0.002] in patients with and without diabetes, respectively). In the multivariable analysis, diabetes remained as an independent risk factor both for overall and cardiovascular mortality. No significant interaction was found with other clinical variables. Conclusion: Among patients in whom an elective invasive cardiac procedure is cancelled or postponed during COVID-19 pandemic, mortality and cardiovascular mortality is higher in patients with diabetes, irrespectively on other clinical conditions. These procedures should not be cancelled in patients with diabetes.

3.
PLoS One ; 16(7): e0255263, 2021.
Article in English | MEDLINE | ID: covidwho-1332005

ABSTRACT

BACKGROUND: Patients presenting with the coronavirus-2019 disease (COVID-19) may have a high risk of cardiovascular adverse events, including death from cardiovascular causes. The long-term cardiovascular outcomes of these patients are entirely unknown. We aim to perform a registry of patients who have undergone a diagnostic nasopharyngeal swab for SARS-CoV-2 and to determine their long-term cardiovascular outcomes. STUDY AND DESIGN: This is a multicenter, observational, retrospective registry to be conducted at 17 centers in Spain and Italy (ClinicalTrials.gov number: NCT04359927). Consecutive patients older than 18 years, who underwent a real-time reverse transcriptase-polymerase chain reaction (RT-PCR) for SARS-CoV2 in the participating institutions, will be included since March 2020, to August 2020. Patients will be classified into two groups, according to the results of the RT-PCR: COVID-19 positive or negative. The primary outcome will be cardiovascular mortality at 1 year. The secondary outcomes will be acute myocardial infarction, stroke, heart failure hospitalization, pulmonary embolism, and serious cardiac arrhythmias, at 1 year. Outcomes will be compared between the two groups. Events will be adjudicated by an independent clinical event committee. CONCLUSION: The results of this registry will contribute to a better understanding of the long-term cardiovascular implications of the COVID19.


Subject(s)
Arrhythmias, Cardiac/etiology , COVID-19/complications , Cardiovascular System/virology , Heart Failure/etiology , Myocardial Infarction/etiology , Stroke/etiology , Arrhythmias, Cardiac/virology , Female , Heart Failure/virology , Humans , Italy , Male , Myocardial Infarction/virology , Pulmonary Embolism/etiology , Pulmonary Embolism/virology , Registries , Retrospective Studies , Spain , Stroke/virology , Time Factors , Treatment Outcome
6.
Cardiovasc Diabetol ; 20(1): 69, 2021 03 23.
Article in English | MEDLINE | ID: covidwho-1148218

ABSTRACT

BACKGROUND: During COVID-19 pandemic, elective invasive cardiac procedures (ICP) have been frequently cancelled or postponed. Consequences may be more evident in patients with diabetes. OBJECTIVES: The objective was to identify the peculiarities of patients with DM among those in whom ICP were cancelled or postponed due to the COVID-19 pandemic, as well as to identify subgroups in which the influence of DM has higher impact on the clinical outcome. METHODS: We included 2,158 patients in whom an elective ICP was cancelled or postponed during COVID-19 pandemic in 37 hospitals in Spain. Among them, 700 (32.4%) were diabetics. Patients with and without diabetes were compared. RESULTS: Patients with diabetes were older and had a higher prevalence of other cardiovascular risk factors, previous cardiovascular history and co-morbidities. Diabetics had a higher mortality (3.0% vs. 1.0%; p = 0.001) and cardiovascular mortality (1.9% vs. 0.4%; p = 0.001). Differences were especially important in patients with valvular heart disease (mortality 6.9% vs 1.7% [p < 0.001] and cardiovascular mortality 4.9% vs 0.9% [p = 0.002] in patients with and without diabetes, respectively). In the multivariable analysis, diabetes remained as an independent risk factor both for overall and cardiovascular mortality. No significant interaction was found with other clinical variables. CONCLUSION: Among patients in whom an elective invasive cardiac procedure is cancelled or postponed during COVID-19 pandemic, mortality and cardiovascular mortality is higher in patients with diabetes, irrespectively on other clinical conditions. These procedures should not be cancelled in patients with diabetes.


Subject(s)
COVID-19 , Coronary Angiography , Diabetes Mellitus , Heart Diseases/diagnostic imaging , Heart Diseases/therapy , Percutaneous Coronary Intervention , Time-to-Treatment , Waiting Lists , Age Factors , Aged , Aged, 80 and over , Comorbidity , Databases, Factual , Diabetes Mellitus/diagnosis , Diabetes Mellitus/mortality , Female , Heart Diseases/mortality , Humans , Male , Middle Aged , Prevalence , Risk Assessment , Risk Factors , Spain/epidemiology , Time Factors , Waiting Lists/mortality
7.
Catheter Cardiovasc Interv ; 97(5): 927-937, 2021 04 01.
Article in English | MEDLINE | ID: covidwho-985973

ABSTRACT

BACKGROUND: During COVID-19 pandemic in Spain, elective procedures were canceled or postponed, mainly due to health care systems overwhelming. OBJECTIVE: The objective of this study was to evaluate the consequences of interrupting invasive procedures in patients with chronic cardiac diseases due to the COVID-19 outbreak in Spain. METHODS: The study population is comprised of 2,158 patients that were pending on elective cardiac invasive procedures in 37 hospitals in Spain on the 14th of March 2020, when a state of alarm and subsequent lockdown was declared in Spain due to the COVID-19 pandemic. These patients were followed-up until April 31th. RESULTS: Out of the 2,158 patients, 36 (1.7%) died. Mortality was significantly higher in patients pending on structural procedures (4.5% vs. 0.8%, respectively; p < .001), in those >80 year-old (5.1% vs. 0.7%, p < .001), and in presence of diabetes (2.7% vs. 0.9%, p = .001), hypertension (2.0% vs. 0.6%, p = .014), hypercholesterolemia (2.0% vs. 0.9%, p = .026) [Correction added on December 23, 2020, after first online publication: as per Dr. Moreno's request changes in p-values were made after original publication in Abstract.], chronic renal failure (6.0% vs. 1.2%, p < .001), NYHA > II (3.8% vs. 1.2%, p = .001), and CCS > II (4.2% vs. 1.4%, p = .013), whereas was it was significantly lower in smokers (0.5% vs. 1.9%, p = .013). Multivariable analysis identified age > 80, diabetes, renal failure and CCS > II as independent predictors for mortality. CONCLUSION: Mortality at 45 days during COVID-19 outbreak in patients with chronic cardiovascular diseases included in a waiting list due to cancellation of invasive elective procedures was 1.7%. Some clinical characteristics may be of help in patient selection for being promptly treated when similar situations happen in the future.


Subject(s)
COVID-19/epidemiology , Cardiac Surgical Procedures/statistics & numerical data , Cardiovascular Diseases/surgery , Elective Surgical Procedures/statistics & numerical data , Pandemics , SARS-CoV-2 , Waiting Lists , Aged , Aged, 80 and over , Cardiovascular Diseases/epidemiology , Comorbidity , Female , Humans , Male , Spain/epidemiology
8.
Catheter Cardiovasc Interv ; 97(5): E670-E672, 2021 04 01.
Article in English | MEDLINE | ID: covidwho-691022

ABSTRACT

Myocardial injury is frequently detected in coronavirus disease 2019 (COVID-19) patients. However, up to one-third of COVID-19 patients showing ST-segment elevation on the electrocardiogram have angiographically normal coronary arteries. We present a case of an acute coronary syndrome due to a coronary spasm in a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) patient. This pathophysiological mechanism was clearly demonstrated by intracoronary imaging techniques (optical coherence tomography) and invasive vasospasm test.


Subject(s)
COVID-19/complications , Coronary Angiography/methods , Coronary Vasospasm/etiology , Electrocardiography , Aged , COVID-19/epidemiology , Coronary Vasospasm/diagnosis , Humans , Male , Pandemics , SARS-CoV-2
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