PMID- 33644297
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220420
IS  - 2352-9067 (Print)
IS  - 2352-9067 (Electronic)
IS  - 2352-9067 (Linking)
VI  - 33
DP  - 2021 Apr
TI  - COVID-19 and changes in activity and treatment of ST elevation MI from a UK 
      cardiac centre.
PG  - 100736
LID - 10.1016/j.ijcha.2021.100736 [doi]
LID - 100736
AB  - BACKGROUND: The international healthcare response to COVID-19 has been driven by 
      epidemiological data related to case numbers and case fatality rate. Second order 
      effects have been less well studied. This study aimed to characterise the changes 
      in emergency activity of a high-volume cardiac catheterisation centre and to 
      cautiously model any excess indirect morbidity and mortality. METHOD: 
      Retrospective cohort study of patients admitted with acute coronary syndrome 
      fulfilling criteria for the heart attack centre (HAC) pathway at St. 
      Bartholomew's hospital, UK. Electronic data were collected for the study period 
      March 16th - May 16th 2020 inclusive and stored on a dedicated research server. 
      Standard governance procedures were observed in line with the British 
      Cardiovascular Intervention Society audit. RESULTS: There was a 28% fall in the 
      number of primary percutaneous coronary interventions (PCIs) for ST elevation 
      myocardial infarction (STEMI) during the study period (111 vs. 154) and 36% fewer 
      activations of the HAC pathway (312 vs. 485), compared to the same time period 
      averaged across three preceding years. In the context of 'missing STEMIs', the 
      excess harm attributable to COVID-19 could result in an absolute increase of 1.3% 
      in mortality, 1.9% in nonfatal MI and 4.5% in recurrent ischemia. CONCLUSIONS: 
      The emergency activity of a high-volume PCI centre was significantly reduced for 
      STEMI during the peak of the first wave of COVID-19. Our data can be used as an 
      exemplar to help future modelling within cardiovascular workstreams to refine 
      aggregate estimates of the impact of COVID-19 and inform targeted policy action.
CI  - (c) 2021 Published by Elsevier B.V.
FAU - Chen, Yang
AU  - Chen Y
AD  - Institute of Cardiovascular Science, University College London, UK.
AD  - St Bartholomew's Hospital, Barts Health NHS Trust, London, UK.
FAU - Rathod, Krishnaraj S
AU  - Rathod KS
AD  - St Bartholomew's Hospital, Barts Health NHS Trust, London, UK.
AD  - Centre for Cardiovascular Medicines and Devices, Queen Mary University London, 
      UK.
FAU - Hamshere, Stephen
AU  - Hamshere S
AD  - St Bartholomew's Hospital, Barts Health NHS Trust, London, UK.
AD  - Centre for Cardiovascular Medicines and Devices, Queen Mary University London, 
      UK.
FAU - Choudry, Fizzah
AU  - Choudry F
AD  - St Bartholomew's Hospital, Barts Health NHS Trust, London, UK.
AD  - Centre for Cardiovascular Medicines and Devices, Queen Mary University London, 
      UK.
FAU - Akhtar, Mohammed M
AU  - Akhtar MM
AD  - St Bartholomew's Hospital, Barts Health NHS Trust, London, UK.
AD  - Centre for Cardiovascular Medicines and Devices, Queen Mary University London, 
      UK.
FAU - Curtis, Miles
AU  - Curtis M
AD  - St Bartholomew's Hospital, Barts Health NHS Trust, London, UK.
FAU - Amersey, Rajiv
AU  - Amersey R
AD  - St Bartholomew's Hospital, Barts Health NHS Trust, London, UK.
FAU - Guttmann, Oliver
AU  - Guttmann O
AD  - St Bartholomew's Hospital, Barts Health NHS Trust, London, UK.
FAU - O'Mahony, Constantinos
AU  - O'Mahony C
AD  - Institute of Cardiovascular Science, University College London, UK.
AD  - St Bartholomew's Hospital, Barts Health NHS Trust, London, UK.
FAU - Jain, Ajay
AU  - Jain A
AD  - St Bartholomew's Hospital, Barts Health NHS Trust, London, UK.
AD  - Centre for Cardiovascular Medicines and Devices, Queen Mary University London, 
      UK.
FAU - Wragg, Andrew
AU  - Wragg A
AD  - St Bartholomew's Hospital, Barts Health NHS Trust, London, UK.
AD  - Centre for Cardiovascular Medicines and Devices, Queen Mary University London, 
      UK.
FAU - Baumbach, Andreas
AU  - Baumbach A
AD  - St Bartholomew's Hospital, Barts Health NHS Trust, London, UK.
AD  - Centre for Cardiovascular Medicines and Devices, Queen Mary University London, 
      UK.
FAU - Mathur, Anthony
AU  - Mathur A
AD  - St Bartholomew's Hospital, Barts Health NHS Trust, London, UK.
AD  - Centre for Cardiovascular Medicines and Devices, Queen Mary University London, 
      UK.
FAU - Jones, Daniel A
AU  - Jones DA
AD  - St Bartholomew's Hospital, Barts Health NHS Trust, London, UK.
AD  - Centre for Cardiovascular Medicines and Devices, Queen Mary University London, 
      UK.
LA  - eng
PT  - Journal Article
DEP - 20210223
PL  - Ireland
TA  - Int J Cardiol Heart Vasc
JT  - International journal of cardiology. Heart & vasculature
JID - 101649525
PMC - PMC7901371
OTO - NOTNLM
OT  - COVID-19
OT  - Indirect morbidity and mortality
OT  - STEMI
OT  - Thrombolysis
EDAT- 2021/03/02 06:00
MHDA- 2021/03/02 06:01
PMCR- 2021/02/23
CRDT- 2021/03/01 05:40
PHST- 2020/07/03 00:00 [received]
PHST- 2021/01/29 00:00 [revised]
PHST- 2021/02/03 00:00 [accepted]
PHST- 2021/03/01 05:40 [entrez]
PHST- 2021/03/02 06:00 [pubmed]
PHST- 2021/03/02 06:01 [medline]
PHST- 2021/02/23 00:00 [pmc-release]
AID - S2352-9067(21)00024-5 [pii]
AID - 100736 [pii]
AID - 10.1016/j.ijcha.2021.100736 [doi]
PST - ppublish
SO  - Int J Cardiol Heart Vasc. 2021 Apr;33:100736. doi: 10.1016/j.ijcha.2021.100736. 
      Epub 2021 Feb 23.