scholarly journals Impact on percutaneous coronary intervention for acute coronary syndromes during the COVID-19 outbreak in a non-overwhelmed European healthcare system: COVID-19 ACS-PCI experience in Ireland

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e045590
Author(s):  
Niall Patrick Connolly ◽  
Andrew Simpkin ◽  
Darren Mylotte ◽  
James Crowley ◽  
Stephen O'Connor ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Healthcare System ◽  
Acute Coronary Syndromes ◽  
Coronary Intervention ◽  
Medical Attention ◽  
Cardiac Symptoms ◽  
European Healthcare ◽  
Percutaneous Coronary ◽  
Coronary Syndromes ◽  
St Elevation

AimsTo evaluate temporal trends of acute coronary syndromes (ACS) treated via percutaneous coronary intervention (PCI) throughout the COVID-19 outbreak in a European healthcare system affected but not overwhelmed by COVID-19-related pathology.Methods and resultsWe performed a retrospective multicentre analysis of the rates of PCI for the treatment of ACS within the period 2 months pre and post the first confirmed COVID-19 case in Ireland, as well as comparing PCI for ST-elevation myocardial infarction (STEMI) with the corresponding period in 2019. During the 2020 COVID-19 period (29 February–30 April 2020), there was a 24% decline in PCI for overall ACS (incidence rate ratio (IRR) 0.76; 95% CI 0.65 to 0.88; p<0.001), including a 29% reduction in PCI for non-ST-elevation ACS (IRR 0.71; 95% CI 0.57 to 0.88; p=0.002) and an 18% reduction in PCI for STEMI (IRR 0.82; 95% CI 0.67 to 1.01; p=0.061), as compared with the 2020 pre-COVID-19 period (1 January–28 February 2020). A 22% (IRR 0.78; 95% CI 0.65 to 0.93; p=0.005) reduction of PCI for STEMI was seen as compared with the 2019 reference period.ConclusionThis study demonstrates a significant reduction in PCI procedures for the treatment of ACS since the COVID-19 outbreak in Ireland. The reasons for this decline are still unclear but patients need to be encouraged to seek medical attention when cardiac symptoms appear, in order to avoid incremental cardiac morbidity and mortality due to a reduction in coronary revascularisation for the treatment of ACS.

Early versus delayed percutaneous coronary intervention in patients with non-ST elevation acute coronary syndromes

2016 ◽  
Vol 27 (5) ◽  
pp. 344-349 ◽  
Author(s):  
Matias B. Yudi ◽  
Andrew E. Ajani ◽  
Nick Andrianopoulos ◽  
Stephen J. Duffy ◽  
Omar Farouque ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Acute Coronary Syndromes ◽  
Coronary Intervention ◽  
Percutaneous Coronary ◽  
Coronary Syndromes ◽  
St Elevation

Abstract 3202: Gender Differences Among Patients with Acute Coronary Syndromes Undergoing Percutaneous Coronary Intervention in the ACC/NCDR PCI Registry

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Nausheen Akhter ◽  
Sarah Milford-Beland ◽  
Matthew T Roe ◽  
Adhir R Shroff
Keyword(s):  
Gender Differences ◽  
Percutaneous Coronary Intervention ◽  
Acute Coronary Syndromes ◽  
Clinical Characteristics ◽  
Coronary Intervention ◽  
Percutaneous Coronary ◽  
Procedural Complications ◽  
Coronary Syndromes ◽  
St Elevation ◽  
Adjusted Rate

Background : Cardiovascular disease is the leading cause of death in women. Prior studies have demonstrated gender disparities in the management and outcomes of women with acute coronary syndromes (ACS). Objectives : We sought to explore if gender differences exist in a patient population who present with ACS and have a percutaneous coronary intervention (PCI) during hospitalization in a large, contemporary national PCI registry, the American College of Cardiology National Cardiovascular Data Registry (ACC-NCDR). Methods : We analyzed ACS patients who had a PCI in the ACC-NCDR PCI registry from January 1, 2004 to March 30, 2006. Clinical characteristics, procedural and clinical outcomes, and concomitant medical therapies were compared between men and women according to ACS status: unstable angina (UA)/non-ST elevation MI (NSTEMI) and ST elevation MI (STEMI). Results : Of 199,690 patients with ACS who underwent PCI, women more often presented with unstable angina (57.7% vs. 53.9%), equally with NSTEMI (24.2% vs. 23.6%), and less often with STEMI (18.1% vs. 22.6%) compared with men. In both ACS categories, women were older and had a higher incidence of diabetes (insulin or non-insulin dependent), HTN, PVD, CVA, past and current CHF and renal failure. There was also a higher incidence of cardiogenic shock in women among the STEMI population. The use of drug eluting stents was similar among women and men, but women were less likely to receive aspirin, GP IIb-IIIa inhibitors, and discharge aspirin and statins compared with men. While the adjusted rate of in-hospital mortality was similar among women and men, women had higher rates of peri-procedural complications, including more cardiogenic shock, CHF, bleeding and vascular complications. Rates of subacute stent thrombosis were similar between genders. Conclusions : Women with ACS who underwent PCI were older and more likely to have comorbidities compared with men, and were more likely to have procedural complications. Whether these differences were related to the observed differences in a number of evidence-based medications or clinical characteristics among women vs. men will require further study. Adjusted rate of in-hospital mortality was similar among women and men.

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