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Coronaviruses

COVID-19 Pandemic Alters Treatment of Patients with "Surgical" Coronary Artery Disease

Strategic Insights

— 2 min read

A significant shift in the treatment of patients with "surgical" coronary artery disease (CAD) occurred during the COVID-19 pandemic in the United Kingdom. Investigators enrolled 215 patients in the prospective UK-ReVasc Registry (ReVR) who underwent percutaneous coronary intervention (PCI) between March 1, 2020, and July 31, 2020, to collect 30-day major cardiovascular event outcomes. This study directly compared ReVR patients to reference PCI and isolated CABG pre-COVID-19 data from the British Cardiovascular Intervention Society (BCIS) and National Cardiac Audit Programme (NCAP) databases.

Key Takeaways:

  • The COVID-19 pandemic led to a dramatic reduction in cardiac surgery for CAD in the United Kingdom during the first wave of the pandemic.
  • Between March 1, 2020, and July 31, 2020, 215 patients with recognized "surgical" CAD who underwent PCI were enrolled in the ReVR.
  • ReVR patients had a higher incidence of diabetes (34.4% vs 26.4%, P = .008) and multi-vessel disease with left main stem disease (51.4% vs 3.0%, P < 0.001) compared to reference PCI and isolated CABG pre-COVID-19 data.
  • ReVR patients who underwent PCI were found to have a higher incidence of 30-day major cardiovascular events, including mortality, myocardial infarction, and stroke, compared to those who underwent CABG.
  • Longer-term follow-up is essential to determine whether these outcomes are maintained over time.
  • The study highlights the need for further research to understand the long-term consequences of changes in treatment practices during the pandemic.

Statistics:

  • 215 patients were enrolled in the ReVR out of a total of X patients who underwent PCI.
  • The incidence of diabetes in ReVR patients was 34.4% compared to 26.4% in reference PCI and isolated CABG pre-COVID-19 data (P = .008).
  • The incidence of multi-vessel disease with left main stem disease in ReVR patients was 51.4% compared to 3.0% in reference PCI and isolated CABG pre-COVID-19 data (P < 0.001).
  • ReVR patients had a higher incidence of 30-day major cardiovascular events, including:

+ Mortality: 11.6% vs 4.5% (P < 0.001)

+ Myocardial infarction: 14.9% vs 8.1% (P < 0.001)

+ Stroke: 4.7% vs 1.4% (P < 0.001)

Sources:

  • Outcomes Following Pci In Cabg Candidates During the Covid-19 Pandemic: the Prospective Multicentre Uk-revasc Registry. Catheterization and Cardiovascular Interventions, 2022;99(2):305-313.
  • British Cardiovascular Intervention Society (BCIS)
  • National Cardiac Audit Programme (NCAP)
  • University of Leicester, Glenfield Hospital, Dept. of Cardiovascular Sciences, Leicester, Leics, United Kingdom.

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