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1. Impact of diabetes in patients waiting for invasive cardiac procedures during COVID-19 pandemic

Author

Raúl Moreno, José-Luis Díez, José-Antonio Diarte, Pablo Salinas, José María de la Torre Hernández, Juan F. Andres-Cordón, Ramiro Trillo, Juan Alonso Briales, Ignacio Amat-Santos, Rafael Romaguera, José-Francisco Díaz, Beatriz Vaquerizo, Soledad Ojeda, Ignacio Cruz-González, Daniel Morena-Salas, Armando Pérez de Prado, Fernando Sarnago, Pilar Portero, Alejandro Gutierrez-Barrios, Fernando Alfonso, Eduard Bosch, Eduardo Pinar, José-Ramón Ruiz-Arroyo, Valeriano Ruiz-Quevedo, Jesús Jiménez-Mazuecos, Fernando Lozano, José-Ramón Rumoroso, Enrique Novo, Francisco J. Irazusta, Bruno García del Blanco, José Moreu, Sara M. Ballesteros-Pradas, Araceli Frutos, Manuel Villa, Eduardo Alegría-Barrero, Rosa Lázaro, and Emilio Paredes

Subjects
Diabetes, Interventional cardiology, COVID-19, Mortality, Waiting list, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Abstract Background During COVID-19 pandemic, elective invasive cardiac procedures (ICP) have been frequently cancelled or postponed. Consequences may be more evident in patients with diabetes. Objectives The objective was to identify the peculiarities of patients with DM among those in whom ICP were cancelled or postponed due to the COVID-19 pandemic, as well as to identify subgroups in which the influence of DM has higher impact on the clinical outcome. Methods We included 2,158 patients in whom an elective ICP was cancelled or postponed during COVID-19 pandemic in 37 hospitals in Spain. Among them, 700 (32.4%) were diabetics. Patients with and without diabetes were compared. Results Patients with diabetes were older and had a higher prevalence of other cardiovascular risk factors, previous cardiovascular history and co-morbidities. Diabetics had a higher mortality (3.0% vs. 1.0%; p = 0.001) and cardiovascular mortality (1.9% vs. 0.4%; p = 0.001). Differences were especially important in patients with valvular heart disease (mortality 6.9% vs 1.7% [p

Published
2021
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2. Impact of diabetes in patients waiting for invasive cardiac procedures during COVID-19 pandemic

Author

J. Díaz, Eduardo Alegría-Barrero, Fernando Alfonso, Jesús Jiménez-Mazuecos, José Moreu, José-Ramón Ruiz-Arroyo, José-Antonio Diarte, Bruno García del Blanco, Sara M Ballesteros-Pradas, Fernando Sarnago, Araceli Frutos, Valeriano Ruiz-Quevedo, José M. de la Torre Hernández, José-Luis Díez, Ignacio Cruz-González, Eduardo Pinar, Pablo Salinas, Armando Pérez de Prado, Rosa Lázaro, Emilio Paredes, Ramiro Trillo, Juan F Andres-Cordón, Manuel Villa, Soledad Ojeda, Juan H. Alonso Briales, Eduard Bosch, Raul Moreno, Daniel Morena-Salas, Alejandro Gutierrez-Barrios, Francisco Javier Irazusta, Beatriz Vaquerizo, Jose-Ramon Rumoroso, Enrique Novo, Pilar Portero, Fernando Lozano, Rafael Romaguera, Ignacio J. Amat-Santos, Institut Català de la Salut, [Moreno R] University Hospital La Paz, idiPAZ, Madrid, Spain. [Díez JL] Hospital La Fe, Valencia, Spain. [Diarte JA] Hospital Miguel Servet, Zaragoza, Spain. [Salinas P] Hospital Clínico San Carlos, Madrid, Spain. [de la Torre Hernández JM] Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain. [Andres-Cordón JF] Hospital German Trias I Pujol, Badalona, Spain. [García Del Blanco B] Vall d’Hebron Hospital Universitari, Barcelona, Spain, and Vall d'Hebron Barcelona Hospital Campus

Subjects
Male, lcsh:Diseases of the circulatory (Cardiovascular) system, Time Factors, Databases, Factual, genetic structures, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Waiting list, enfermedades del sistema endocrino::diabetes mellitus [ENFERMEDADES], Comorbidity, Coronary Angiography, Cor - Cirurgia, Risk Factors, Diabetis - Mortalitat - Espanya, Prevalence, virosis::infecciones por virus ARN::infecciones por Nidovirales::infecciones por Coronaviridae::infecciones por Coronavirus [ENFERMEDADES], Pandèmia de COVID-19, 2020, Surgical Procedures, Operative::Cardiovascular Surgical Procedures::Vascular Surgical Procedures::Endovascular Procedures::Percutaneous Coronary Intervention [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT], Original Investigation, Aged, 80 and over, Diabetis, valvular heart disease, Diabetes, Age Factors, Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections [DISEASES], Middle Aged, Female, Cardiology and Cardiovascular Medicine, Risk assessment, Interventional cardiology, medicine.medical_specialty, Heart Diseases, Waiting Lists, Cardiology, Risk Assessment, Time-to-Treatment, Cardiologia, Percutaneous Coronary Intervention, Diabetes mellitus, Internal medicine, Other subheadings::Other subheadings::Other subheadings::/mortality [Other subheadings], Diabetes Mellitus, medicine, Mortalitat, Humans, Risk factor, Mortality, Endocrine System Diseases::Diabetes Mellitus [DISEASES], Aged, intervenciones quirúrgicas::procedimientos quirúrgicos cardiovasculares::procedimientos quirúrgicos vasculares::procedimientos endovasculares::cirugía coronaria percutánea [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS], Otros calificadores::Otros calificadores::Otros calificadores::/mortalidad [Otros calificadores], Cardiovascular History, business.industry, Percutaneous coronary intervention, COVID-19, medicine.disease, Spain, lcsh:RC666-701, business
Abstract

Background During COVID-19 pandemic, elective invasive cardiac procedures (ICP) have been frequently cancelled or postponed. Consequences may be more evident in patients with diabetes. Objectives The objective was to identify the peculiarities of patients with DM among those in whom ICP were cancelled or postponed due to the COVID-19 pandemic, as well as to identify subgroups in which the influence of DM has higher impact on the clinical outcome. Methods We included 2,158 patients in whom an elective ICP was cancelled or postponed during COVID-19 pandemic in 37 hospitals in Spain. Among them, 700 (32.4%) were diabetics. Patients with and without diabetes were compared. Results Patients with diabetes were older and had a higher prevalence of other cardiovascular risk factors, previous cardiovascular history and co-morbidities. Diabetics had a higher mortality (3.0% vs. 1.0%; p = 0.001) and cardiovascular mortality (1.9% vs. 0.4%; p = 0.001). Differences were especially important in patients with valvular heart disease (mortality 6.9% vs 1.7% [p Conclusion Among patients in whom an elective invasive cardiac procedure is cancelled or postponed during COVID-19 pandemic, mortality and cardiovascular mortality is higher in patients with diabetes, irrespectively on other clinical conditions. These procedures should not be cancelled in patients with diabetes.

Published
2021

3. Consequences of canceling elective invasive cardiac procedures during Covid‐19 outbreak

Author

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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