# 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.

## Key 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.