1. Consequences of canceling elective invasive cardiac procedures during Covid‐19 outbreak
- Author
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Ramiro Trillo, Bruno García del Blanco, Fernando Macaya, José-Luis Díez, Daniel Morena-Salas, Juan H. Alonso-Briales, Ignacio J. Amat-Santos, José-Ramón Ruiz-Arroyo, Jose-Ramon Rumoroso, Alejandro Gutierrez-Barrios, José-Antonio Diarte, Jesús Jiménez-Mazuecos, Ignacio Cruz-González, Eduard Bosch, Raúl Moreno, Fernando Sarnago, Araceli Frutos, Fernando Alfonso, José Moreu, Eduardo Pinar, Soledad Ojeda, Sara M Ballesteros-Pradas, Francisco Javier Irazusta, Enrique Novo, Rosa Lázaro, Fernando Lozano, Rafael Romaguera, Emilio Paredes, Valeriano Ruiz-Quevedo, Armando Pérez de Prado, J. Díaz, Manuel Villa, José-María de la Torrre Hernández, Eduardo Alegría-Barrero, Oriol Rodríguez-Leor, Pilar Portero, and Beatriz Vaquerizo
- Subjects
Male ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,Waiting Lists ,diagnostic ,Comorbidity ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Diabetes mellitus ,Health care ,Cardiac procedures ,Pandemic ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,In patient ,030212 general & internal medicine ,Cardiac Surgical Procedures ,Pandemics ,catheterization ,health care economics and organizations ,Aged ,Aged, 80 and over ,transcatheter valve implantation (TVI) ,business.industry ,SARS-CoV-2 ,Outbreak ,COVID-19 ,General Medicine ,medicine.disease ,catheterization, diagnostic, percutaneous coronary intervention (PCI), transcatheter valve implantation (TVI) ,Cardiovascular Diseases ,Elective Surgical Procedures ,Spain ,Radiology Nuclear Medicine and imaging ,Emergency medicine ,Population study ,Female ,percutaneous coronary intervention (PCI) ,business ,Cardiology and Cardiovascular Medicine ,human activities - Abstract
BACKGROUND: During COVID-19 pandemic in Spain, elective procedures were canceled or postponed, mainly due to health care systems overwhelming. OBJECTIVE: The objective of this study was to evaluate the consequences of interrupting invasive procedures in patients with chronic cardiac diseases due to the COVID-19 outbreak in Spain. METHODS: The study population is comprised of 2,158 patients that were pending on elective cardiac invasive procedures in 37 hospitals in Spain on the 14th of March 2020, when a state of alarm and subsequent lockdown was declared in Spain due to the COVID-19 pandemic. These patients were followed-up until April 31th. RESULTS: Out of the 2,158 patients, 36 (1.7%) died. Mortality was significantly higher in patients pending on structural procedures (4.5% vs. 0.8%, respectively; p < .001), in those >80 year-old (5.1% vs. 0.7%, p < .001), and in presence of diabetes (2.7% vs. 0.9%, p = .001), hypertension (2.0% vs. 0.6%, p = .014), hypercholesterolemia (2.0% vs. 0.9%, p = .026) [Correction added on December 23, 2020, after first online publication: as per Dr. Moreno's request changes in p-values were made after original publication in Abstract.], chronic renal failure (6.0% vs. 1.2%, p < .001), NYHA > II (3.8% vs. 1.2%, p = .001), and CCS > II (4.2% vs. 1.4%, p = .013), whereas was it was significantly lower in smokers (0.5% vs. 1.9%, p = .013). Multivariable analysis identified age > 80, diabetes, renal failure and CCS > II as independent predictors for mortality. CONCLUSION: Mortality at 45 days during COVID-19 outbreak in patients with chronic cardiovascular diseases included in a waiting list due to cancellation of invasive elective procedures was 1.7%. Some clinical characteristics may be of help in patient selection for being promptly treated when similar situations happen in the future.
- Published
- 2020
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