Effect of COVID-19 Pandemic on Acute Coronary Syndrome Clinical Practice Patterns: Findings from a Multicenter Clinician Survey in China

TL;DR

This study shows how the COVID-19 pandemic changed how doctors treat heart attacks and related conditions in China.

Contribution

The study provides new insights into how the pandemic altered clinical decisions for acute coronary syndrome in China.

Findings

Cardiologists reported fewer acute coronary syndrome patients during the pandemic.

Invasive treatments like coronary interventions decreased, while drug treatments increased.

Fibrinolytic therapy for heart attacks was used more often during the pandemic.

Abstract

The
coronavirus disease 2019 (COVID-19) pandemic has severely affected healthcare
systems around the world. This study aimed to investigate the perceptions of
cardiologists regarding how the COVID-19 pandemic has affected the clinical
practice patterns for acute coronary syndrome (ACS).

A
multicenter clinician survey was sent to 300 cardiologists working in 22
provinces in China. The survey collected demographic information and inquired
about their perceptions of how the COVID-19 pandemic has affected ACS clinical
practice patterns.

The survey was completed by 211 (70.3%)
cardiologists, 82.5% of whom were employed in tertiary hospitals, and 52.1%
reported more than 10 years of clinical cardiology practice. Most respondents
observed a reduction in ACS inpatients and outpatients in their hospitals during
the pandemic. Only 29.9% of the respondents had access to a dedicated catheter
room for the treatment of COVID-19-positive ACS patients. Most respondents stated
that the COVID-19 pandemic had varying degrees of effect on the treatment of
acute ST-segment elevation myocardial infarction (STEMI), acute non-ST-segment
elevation myocardial infarction (NSTEMI), and unstable angina. Compared with the
assumed non-pandemic period, in the designed clinical questions, the selection of
coronary interventional therapy for STEMI, NSTEMI, and unstable angina during the
COVID-19 pandemic was significantly decreased (all p < 0.05), and the
selection of pharmacotherapy was increased (all p < 0.05). The
selection of fibrinolytic therapy for STEMI during the pandemic was higher than
in the assumed non-pandemic period (p < 0.05).

The COVID-19 pandemic has profoundly affected ACS
clinical practice patterns. The use of invasive therapies significantly decreased
during the pandemic period, whereas pharmacotherapy was more often prescribed by
the cardiologists.

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