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Impact of the COVID-19 Pandemic on Percutaneous Coronary Intervention in England: Insights From the British Cardiovascular Intervention Society PCI Database Cohort.
Kwok, Chun Shing; Gale, Chris P; Curzen, Nick; de Belder, Mark A; Ludman, Peter; Lüscher, Thomas F; Kontopantelis, Evangelos; Roebuck, Chris; Denwood, Tom; Burton, Tony; Hains, Julian; Deanfield, John E; Mamas, Mamas A.
  • Kwok CS; Keele Cardiovascular Research Group, Centre for Prognosis Research, Institute for Primary Care and Health Sciences, Keele University, Stoke-on-Trent, United Kingdom (C.S.K., M.A.M.).
  • Gale CP; Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, United Kingdom (C.S.K., M.A.M.).
  • Curzen N; Leeds Institute of Cardiovascular and Metabolic Medicine (C.P.G.), University of Leeds, United Kingdom.
  • de Belder MA; Leeds Institute for Data Analytics (C.P.G.), University of Leeds, United Kingdom.
  • Ludman P; Department of Cardiology, Leeds Teaching Hospitals NHS Trust, United Kingdom (C.P.G.).
  • Lüscher TF; Wessex Cardiothoracic Unit, Southampton University Hospital Southampton & Faculty of Medicine University of Southampton, United Kingdom (N.C.).
  • Kontopantelis E; National Institute for Cardiovascular Outcomes Research, Barts Health NHS Trust, London, United Kingdom (M.A.d.B., J.H., J.E.D.).
  • Roebuck C; Institute of Cardiovascular Sciences, University of Birmingham, United Kingdom (P.L.).
  • Denwood T; Royal Brompton and Harefield Hospital Trust, Imperial College London, United Kingdom (T.F.L.).
  • Burton T; Centre for Molecular Cardiology, University of Zurich, Switzerland (T.F.L.).
  • Hains J; Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre (MAHSC), The University of Manchester, United Kingdom (E.K.).
  • Deanfield JE; NHS Digital, Leeds, United Kingdom (C.R., T.D., T.B.).
  • Mamas MA; NHS Digital, Leeds, United Kingdom (C.R., T.D., T.B.).
Circ Cardiovasc Interv ; 13(11): e009654, 2020 11.
Article in English | MEDLINE | ID: covidwho-901506
Semantic information from SemMedBD (by NLM)
1. Percutaneous Coronary Intervention TREATS Patients
Subject
Percutaneous Coronary Intervention
Predicate
TREATS
Object
Patients
2. Stable angina PRECEDES Non ST elevated myocardial infarction
Subject
Stable angina
Predicate
PRECEDES
Object
Non ST elevated myocardial infarction
3. Diabetes PROCESS_OF Patients
Subject
Diabetes
Predicate
PROCESS_OF
Object
Patients
4. Percutaneous Coronary Intervention TREATS Stable angina
Subject
Percutaneous Coronary Intervention
Predicate
TREATS
Object
Stable angina
5. Percutaneous Coronary Intervention TREATS Patients
Subject
Percutaneous Coronary Intervention
Predicate
TREATS
Object
Patients
6. Stable angina PRECEDES Non ST elevated myocardial infarction
Subject
Stable angina
Predicate
PRECEDES
Object
Non ST elevated myocardial infarction
7. Diabetes PROCESS_OF Patients
Subject
Diabetes
Predicate
PROCESS_OF
Object
Patients
8. Percutaneous Coronary Intervention TREATS Stable angina
Subject
Percutaneous Coronary Intervention
Predicate
TREATS
Object
Stable angina
ABSTRACT

BACKGROUND:

The objective of the study was to evaluate changes in percutaneous coronary intervention (PCI) practice in England by analyzing procedural numbers, changes in the clinical presentation, and characteristics of patients and their clinical outcomes during the coronavirus disease 2019 (COVID-19) pandemic.

METHODS:

We conducted a retrospective cohort study of all patients who underwent PCI in England between January 2017 and April 2020 in the British Cardiovascular Intervention Society database.

RESULTS:

Forty-four hospitals reported PCI procedures for 126 491 patients. There were ≈700 procedures performed each week before the lockdown. After the March 23, 2020 lockdown (11th/12th week in 2020), there was a 49% fall in the number of PCI procedures after the 12th week in 2020. The decrease was greatest in PCI procedures performed for stable angina (66%), followed by non-ST-segment-elevation myocardial infarction (45%), and ST-segment-elevation myocardial infarction (33%). Patients after the lockdown were younger (64.5 versus 65.5 years, P<0.001) and less likely to have diabetes (20.4% versus 24.6%, P<0.001), hypertension (52.0% versus 56.8%, P=0.001), previous myocardial infarction (23.5% versus 26.7%, P=0.008), previous PCI (24.3% versus 28.3%, P=0.001), or previous coronary artery bypass graft (4.6% versus 7.2%, P<0.001) compared with before the lockdown.

CONCLUSIONS:

The lockdown in England has resulted in a significant decline in PCI procedures. Fewer patients underwent PCI for stable angina. This enabled greater capacity for urgent and emergency cases, and a reduced length of stay was seen for such patients. Significant changes in the characteristics of patients towards a lower risk phenotype were observed, particularly for non-ST-segment-elevation myocardial infarction, reflecting a more conservative approach to this cohort.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Coronavirus Infections / Percutaneous Coronary Intervention / Betacoronavirus Type of study: Observational study / Risk factors Limits: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged / Young adult Country/Region as subject: Europa Language: English Journal: Circ Cardiovasc Interv Journal subject: Vascular Diseases / Cardiology Year: 2020 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Coronavirus Infections / Percutaneous Coronary Intervention / Betacoronavirus Type of study: Observational study / Risk factors Limits: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged / Young adult Country/Region as subject: Europa Language: English Journal: Circ Cardiovasc Interv Journal subject: Vascular Diseases / Cardiology Year: 2020 Document Type: Article