Impact of COVID-19 Pandemic on Cardiovascular Healthcare in Croatia: A Comprehensive Nationwide Survey

TL;DR

This study examines how the Croatian cardiovascular healthcare system adapted during the COVID-19 pandemic, showing resilience and some expansion in critical services.

Contribution

The study provides the first comprehensive nationwide analysis of cardiovascular healthcare utilization changes in Croatia during the pandemic.

Findings

Use of coronary angiographies decreased during the pandemic.

Advanced heart failure treatments and percutaneous coronary interventions increased, especially for acute myocardial infarction.

Transcatheter aortic valve implantations and laboratory tests for troponin and natriuretic peptides saw significant rises.

Abstract

The impact of the COVID-19 pandemic on cardiovascular healthcare in Croatia remains largely unexplored. This study aimed to compare the utilization and provision of cardiovascular services during the pre-pandemic (2017–2019) and pandemic (2020–2021) periods, leveraging nationwide data from the Croatian Health Insurance Fund, which covers 95% of all insurance claims in the country. Our findings reveal that while the use of coronary angiographies decreased during the pandemic, there was a notable increase in the utilization of advanced heart failure treatment modalities and percutaneous coronary interventions, particularly in the context of acute myocardial infarction. Additionally, transcatheter aortic valve implantations saw a significant rise during the pandemic period. Furthermore, laboratory diagnostic testing for troponin and natriuretic peptides experienced a marked increase, while the utilization of most other cardiovascular services remained stable or showed only minor declines compared to the pre-pandemic era. These observations suggest that the Croatian cardiovascular healthcare system displayed resilience during the COVID-19 pandemic, successfully maintaining and even expanding access to various diagnostic and interventional procedures despite facing widespread societal and logistical challenges.