scholarly journals Impact of the 2019 Novel Coronavirus Disease Pandemic on the Performance of a Cardiovascular Department in a Non-epidemic Center in Beijing, China

2021 ◽  
Vol 8 ◽  
Author(s):  
Jing Nan ◽  
Tong Zhang ◽  
Yali Tian ◽  
Ke Song ◽  
Qun Li ◽  
...  

Background: Knowledge of the impact of the 2019 novel coronavirus disease (COVID-19) pandemic on the performance of a cardiovascular department in a medical referral hub center from a non-epidemic area of China is limited.Method: The data on the total number of non-emergency medical cares (including the number of out-patient clinic attendances, the number of patients who were hospitalized in non-intensive care wards, and patients who underwent elective cardiac intervention procedures) and emergency medical cares [including the number of emergency department (ED attendances) and chest pain center (CPC attendances), as well as the number of patients who were hospitalized in coronary care unit (CCU) and the number of patients who underwent emergency cardiac intervention procedures] before and during the pandemic (time before the pandemic: 20th January 2019 to 31st March 2019 and time during the pandemic: 20th January 2020 to 31st March 2020) in the Department of Cardiology and Macrovascular Disease, Beijing Tiantan Hospital, Capital Medical University were collected and compared.Results: Both the non-emergency medical and emergency medical cares were affected by the pandemic. The total number of out-patient clinic attendance decreased by 44.8% and the total number of patients who were hospitalized in non-intensive care wards decreased by 56.4%. Pearson correlation analysis showed that the number of out-patient clinic attendance per day was not associated with the number of new confirmed COVID-19 cases and the cumulative number of confirmed COVID-19 patients in Beijing (r = −0.080, p = 0.506 and r = −0.071, p = 0.552, respectively). The total number of patients who underwent non-emergency cardiac intervention procedures decreased during the pandemic, although there were no statistically significant differences except for patent foramen ovale (PFO) occlusion (1.7 ± 2.9 vs. 8.3 ± 2.3, p = 0.035). As for the emergency medical cares, the ED attendances decreased by 22.4%, the total number of CPC attendances increased by 10.3%, and the number of patients who were hospitalized in CCU increased by 8.9%: these differences were not statistically significant. During the pandemic, the proportion of hospitalized patients with ST segment elevation myocardial infarction (STEMI) and non-ST segment elevation myocardial infarction (NSTEMI) significantly increased (19.0 vs. 8.7%, p < 0.001; 28.8 vs. 18.0%, p < 0.001, respectively); also, the number of primary percutaneous coronary intervention (PCI) increased by 10.3%. There was no significant difference between patients before and during the pandemic regarding the age, gender, baseline and discharge medication therapy, as well as length of stay and in-hospital mortality.Conclusions: Our preliminary results demonstrate that both the non-emergency and emergency medical cares were affected by the COVID-19 pandemic even in a referral medical center with low cross-infection risk. The number of the out-patient clinic attendances not associated with the number of confirmed COVID-19 cases could be due to different factors, such as the local government contamination measures. The proportion of hospitalized patients with acute myocardial infarction increased in our center during the pandemic since other hospitals stopped performing primary angioplasty. A hub-and-spoke model could be effective in limiting the collateral damage for patients affected by cardiovascular diseases when the medical system is stressed by disasters, such as COVID-19 pandemic.

2020 ◽  
Vol 76 ◽  
pp. 58-63 ◽  
Author(s):  
Patrícia O. Guimarães ◽  
Márcio C. Sampaio ◽  
Felipe L. Malafaia ◽  
Renato D. Lopes ◽  
Alexander C. Fanaroff ◽  
...  

2020 ◽  
Vol 33 (6) ◽  
pp. 390
Author(s):  
Júlio Gil Pereira ◽  
Luís Abreu ◽  
Hugo Antunes ◽  
Maria Luísa Gonçalves ◽  
Bruno Marmelo ◽  
...  

Introduction: Emergency medical system transportation has been shown to reduce treatment times in ST-segment elevation myocardial infarction. The authors studied the Portuguese National Registry of Acute Coronary Syndromes to determine the nationwide impact of the emergency medical system transportation in the treatment of ST-segment elevation myocardial infarction.Material and Methods: A multicentric, nationwide, retrospective study of ST-segment elevation myocardial infarction patients inserted in the National Registry from 2010 to 2017 was performed. The patients were divided into: Group I, composed of patients transported by emergency medical system, and Group II, patients arriving to the Emergency department by other means.Results: Of the 5702 patients studied, 25.9% were transported via emergency medical system. Rates of emergency medical system activation increased by 17% in the last 7 years. The emergency medical system provided a higher rate of transport to a percutaneous coronary intervention capable centre, of Emergency department bypass, of on-site fibrinolysis, and ensured a 59-minute reduction of the median reperfusion time (p < 0.001). There was no difference in in-hospital mortality.Discussion: In this nationwide cohort, emergency medical system transportation is associated with a reduction in reperfusion times. It provides a higher amount of salvaged myocardium and reduces the incidence of acute heart failure. However, emergency medical system use did not result in lower in-hospital mortality, probably due to confounding factors of higher disease severity and comorbidity.Conclusion: The benefits associated with emergency medical system based transportation of patients with ST-segment elevation myocardial infarction do not translate into lower in-hospital mortality.


2020 ◽  
Vol 26 (6) ◽  
pp. 11-26
Author(s):  
M. Yu. Sokolov ◽  
Yu. M. Sokolov ◽  
Yu .V. Kashuba

The aim – to evaluate the effect of coronary revascularization (coronary stenting, CS) on the survival of non-ST-segment elevation myocardial infarction (NSTEMI) patients during interventions at different times since the onset of the disease. Materials and methods. The study involved 101 patients with NSTEMI. 29 patients were examined urgently (from 0 to 72 h since the onset of the disease). The remaining 72 patients were hospitalized as scheduled and NSTEMI diagnosis was made between 4 and 180 days before coronary ventriculography or CS. Results and discussion. Patients after CS better tolerated physical activity, they less frequently experienced relapse of angina pectoris and myocardial infarction in comparison with the control group, in which revascularization was not performed. The overall survival of patients with NSTEMI over the 48-month observation period was statistically significantly (p<0.0048) higher in patients who underwent CS than in the control group: 95 % and 80 %, respectively. The cumulative survival without MACE of urgent and planned patients significantly (р=0.002) increased during 48 months of observation in patients who underwent CS and amounted to 78 % compared to 50 % in the control group. Also in the period from 4 to 180 days, the cumulative survival without MACE of NSTEMI patients who underwent SC in a planned manner was significantly higher compared with the control group (p<0.0036): 81 % and 50 %, respectively. In patients after percutaneous interventions, the function of the left ventricle significantly increased and after 48 months of follow-up, the number of patients without disturbances of segmental contractility increased from 82.4 % to 92.4 %. Patients with NSTEMI, who were first diagnosed with dysglycaemia (without diagnosed diabetes mellitus), were more likely to have severe multivessel coronary disease compared with patients who had normal carbohydrate metabolism. Conclusions. Carrying out CS in NSTEMI patients at different times since the onset of the disease statistically significantly increased both overall and cumulative survival of patients. At the same time, the positive effect of CS on cumulative survival without MACE was noted not only in the group of urgent patients, but also in patients who underwent NSTEMI in the period from 4 to 180 days before hospitalization.


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