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. 2021 Apr 1;97(5):927-937.
doi: 10.1002/ccd.29433. Epub 2020 Dec 17.

Consequences of canceling elective invasive cardiac procedures during Covid-19 outbreak

Raúl Moreno  1 , José-Luis Díez  2 , José-Antonio Diarte  3 , Fernando Macaya  4 , José-María de la Torrre Hernández  5 , Oriol Rodríguez-Leor  6 , Ramiro Trillo  7 , Juan Alonso-Briales  8 , Ignacio Amat-Santos  9 , Rafael Romaguera  10 , José-Francisco Díaz  11 , Beatriz Vaquerizo  12 , Soledad Ojeda  13 , Ignacio Cruz-González  14 , Daniel Morena-Salas  15 , Armando Pérez de Prado  16 , Fernando Sarnago  17 , Pilar Portero  18 , Alejandro Gutierrez-Barrios  19 , Fernando Alfonso  20 , Eduard Bosch  21 , Eduardo Pinar  22 , José-Ramón Ruiz-Arroyo  23 , Valeriano Ruiz-Quevedo  24 , Jesús Jiménez-Mazuecos  25 , Fernando Lozano  26 , José-Ramón Rumoroso  27 , Enrique Novo  28 , Francisco J Irazusta  29 , Bruno García Del Blanco  30 , José Moreu  31 , Sara M Ballesteros-Pradas  32 , Araceli Frutos  33 , Manuel Villa  34 , Eduardo Alegría-Barrero  35   36 , Rosa Lázaro  37 , Emilio Paredes  38
Affiliations
Free article

Consequences of canceling elective invasive cardiac procedures during Covid-19 outbreak

Raúl Moreno et al. Catheter Cardiovasc Interv. .
Free article

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.

Keywords: catheterization; diagnostic; percutaneous coronary intervention (PCI); transcatheter valve implantation (TVI).

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References

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