L Derks1, H N Sturkenboom2, M Zaal3, S Houterman4, P Woudstra5, R A Tio2, H P A van Veghel4. 1. Netherlands Heart Registration, Utrecht, The Netherlands. Lineke.derks@nederlandsehartregistratie.nl. 2. Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands. 3. Dutch Hospital Data, Utrecht, The Netherlands. 4. Netherlands Heart Registration, Utrecht, The Netherlands. 5. Department of Cardiology, MCL, Leeuwarden, The Netherlands.
Abstract
BACKGROUND: We aimed to evaluate the association between public media and trends in new presentations of acute coronary syndrome (ACS) during the first wave of the coronavirus disease 2019 (COVID‑19) in the Netherlands. METHODS: New ACS presentations per week in 73 hospitals during the first half of 2019 and 2020 were retrieved from the national organisation Dutch Hospital Data and incidence rates were calculated. Stratified analyses were performed by region, type of ACS and patient characteristics. RESULTS: After the first confirmed COVID‑19 case and during lockdown, numbers declined by up to 41% (95% confidence interval (CI): 36-47%) compared to 2019. This reduction was more pronounced for non-ST-segment elevation myocardial infarction (NSTEMI) (48%; 95% CI: 39-55%) and unstable angina (UA; 50%; 95% CI: 40-59%) than for STEMI (34%; 95% CI: 23-43%). There was no association between ACS and COVID‑19 incidence rate per region. After the steep decline, a public campaign encouraged patients not to postpone hospital visits. Numbers then increased, without a rebound effect. Trends were similar irrespective of sex, age or socio-economic status. During the outbreak, compared to coronary artery bypass graft procedures, relatively more (acute) percutaneous coronary interventions for NSTEMI and UA were performed. CONCLUSION: New ACS presentations decreased by up to 41%. Lockdown measures and public campaigns, rather than COVID‑19 incidence, were associated with significant changes in new ACS presentations. Even though causality cannot be established, this emphasises the role of the public media and healthcare organisations in informing patients to prevent underdiagnoses of ACS and associated health damage.
BACKGROUND: We aimed to evaluate the association between public media and trends in new presentations of acute coronary syndrome (ACS) during the first wave of the coronavirus disease 2019 (COVID‑19) in the Netherlands. METHODS: New ACS presentations per week in 73 hospitals during the first half of 2019 and 2020 were retrieved from the national organisation Dutch Hospital Data and incidence rates were calculated. Stratified analyses were performed by region, type of ACS and patient characteristics. RESULTS: After the first confirmed COVID‑19 case and during lockdown, numbers declined by up to 41% (95% confidence interval (CI): 36-47%) compared to 2019. This reduction was more pronounced for non-ST-segment elevation myocardial infarction (NSTEMI) (48%; 95% CI: 39-55%) and unstable angina (UA; 50%; 95% CI: 40-59%) than for STEMI (34%; 95% CI: 23-43%). There was no association between ACS and COVID‑19 incidence rate per region. After the steep decline, a public campaign encouraged patients not to postpone hospital visits. Numbers then increased, without a rebound effect. Trends were similar irrespective of sex, age or socio-economic status. During the outbreak, compared to coronary artery bypass graft procedures, relatively more (acute) percutaneous coronary interventions for NSTEMI and UA were performed. CONCLUSION: New ACS presentations decreased by up to 41%. Lockdown measures and public campaigns, rather than COVID‑19 incidence, were associated with significant changes in new ACS presentations. Even though causality cannot be established, this emphasises the role of the public media and healthcare organisations in informing patients to prevent underdiagnoses of ACS and associated health damage.
Authors: Andreas Bollmann; Sven Hohenstein; Andreas Meier-Hellmann; Ralf Kuhlen; Gerhard Hindricks Journal: Eur Heart J Qual Care Clin Outcomes Date: 2020-07-01
Authors: Haijiang Dai; Quanyu Zhang; Arsalan Abu Much; Elad Maor; Amit Segev; Roy Beinart; Salim Adawi; Yao Lu; Nicola Luigi Bragazzi; Jianhong Wu Journal: Eur Heart J Qual Care Clin Outcomes Date: 2021-10-28
Authors: Karuna E W Vendrik; Amoe Baktash; Jelle J Goeman; Céline Harmanus; Daan W Notermans; Sabine C de Greeff; Ed J Kuijper Journal: Lancet Reg Health Eur Date: 2022-06-28
Authors: Leonard Simoni; Ilir Alimehmeti; Astrit Ceka; Ermir A Tafaj; Mirald Gina; Aldo Panariti; Fatjon Xhafaj; Alban Dibra; Artan Goda Journal: Cureus Date: 2022-07-13
Authors: Gijs van Steenbergen; Dennis van Veghel; Dideke van Lieshout; Merel Sperwer; Joost Ter Woorst; Lukas Dekker Journal: J Med Internet Res Date: 2022-08-26 Impact factor: 7.076