tetano
Editor, Senior Moderator
Lancet Reg Health West Pac
. 2020 Dec;5:100056.
doi: 10.1016/j.lanwpc.2020.100056. Epub 2020 Nov 20.
The impact of a national COVID-19 lockdown on acute coronary syndrome hospitalisations in New Zealand (ANZACS-QI 55)
Daniel Zl Chan[SUP] 1 2 [/SUP], Ralph Ah Stewart[SUP] 1 [/SUP], Andrew J Kerr[SUP] 2 3 [/SUP], Bridget Dicker[SUP] 4 5 [/SUP], Campbell V Kyle[SUP] 6 7 [/SUP], Philip D Adamson[SUP] 8 9 [/SUP], Gerry Devlin[SUP] 10 [/SUP], John Edmond[SUP] 11 [/SUP], Seif El-Jack[SUP] 12 [/SUP], John M Elliott[SUP] 13 14 [/SUP], Nick Fisher[SUP] 15 [/SUP], Charmaine Flynn[SUP] 16 17 [/SUP], Mildred Lee[SUP] 2 [/SUP], Yi-Wen Becky Liao[SUP] 2 [/SUP], Maxine Rhodes[SUP] 16 [/SUP], Tony Scott[SUP] 1 [/SUP], Tony Smith[SUP] 4 [/SUP], Martin K Stiles[SUP] 18 [/SUP], Andrew H Swain[SUP] 5 19 [/SUP], Verity F Todd[SUP] 4 5 [/SUP], Mark Wi Webster[SUP] 1 [/SUP], Michael Ja Williams[SUP] 20 [/SUP], Harvey D White[SUP] 1 [/SUP], Jithendra B Somaratne[SUP] 1 [/SUP]
Affiliations
Abstract
Background: Countries with a high incidence of coronavirus 2019 (COVID-19) reported reduced hospitalisations for acute coronary syndromes (ACS) during the pandemic. This study describes the impact of a nationwide lockdown on ACS hospitalisations in New Zealand (NZ), a country with a low incidence of COVID-19.
Methods: All patients admitted to a NZ Hospital with ACS who underwent coronary angiography in the All NZ ACS Quality Improvement registry during the lockdown (23 March - 26 April 2020) were compared with equivalent weeks in 2015-2019. Ambulance attendances and regional community troponin-I testing were compared for lockdown and non-lockdown (1 July 2019 to 16 February 2020) periods.
Findings: Hospitalisation for ACS was lower during the 5-week lockdown (105 vs. 146 per-week, rate ratio 0•72 [95% CI 0•61-0•83], p = 0.003). This was explained by fewer admissions for non-ST-segment elevation ACS (NSTE-ACS; p = 0•002) but not ST-segment elevation myocardial infarction (STEMI; p = 0•31). Patient characteristics and in-hospital mortality were similar. For STEMI, door-to-balloon times were similar (70 vs. 72 min, p = 0•52). For NSTE-ACS, there was an increase in percutaneous revascularisation (59% vs. 49%, p<0•001) and reduction in surgical revascularisation (9% vs. 15%, p = 0•005). There were fewer ambulance attendances for cardiac arrests (98 vs. 110 per-week, p = 0•04) but no difference for suspected ACS (408 vs. 420 per-week, p = 0•44). Community troponin testing was lower throughout the lockdown (182 vs. 394 per-week, p<0•001).
Interpretation: Despite the low incidence of COVID-19, there was a nationwide decrease in ACS hospitalisations during the lockdown. These findings have important implications for future pandemic planning.
Funding: The ANZACS-QI registry receives funding from the New Zealand Ministry of Health.
. 2020 Dec;5:100056.
doi: 10.1016/j.lanwpc.2020.100056. Epub 2020 Nov 20.
The impact of a national COVID-19 lockdown on acute coronary syndrome hospitalisations in New Zealand (ANZACS-QI 55)
Daniel Zl Chan[SUP] 1 2 [/SUP], Ralph Ah Stewart[SUP] 1 [/SUP], Andrew J Kerr[SUP] 2 3 [/SUP], Bridget Dicker[SUP] 4 5 [/SUP], Campbell V Kyle[SUP] 6 7 [/SUP], Philip D Adamson[SUP] 8 9 [/SUP], Gerry Devlin[SUP] 10 [/SUP], John Edmond[SUP] 11 [/SUP], Seif El-Jack[SUP] 12 [/SUP], John M Elliott[SUP] 13 14 [/SUP], Nick Fisher[SUP] 15 [/SUP], Charmaine Flynn[SUP] 16 17 [/SUP], Mildred Lee[SUP] 2 [/SUP], Yi-Wen Becky Liao[SUP] 2 [/SUP], Maxine Rhodes[SUP] 16 [/SUP], Tony Scott[SUP] 1 [/SUP], Tony Smith[SUP] 4 [/SUP], Martin K Stiles[SUP] 18 [/SUP], Andrew H Swain[SUP] 5 19 [/SUP], Verity F Todd[SUP] 4 5 [/SUP], Mark Wi Webster[SUP] 1 [/SUP], Michael Ja Williams[SUP] 20 [/SUP], Harvey D White[SUP] 1 [/SUP], Jithendra B Somaratne[SUP] 1 [/SUP]
Affiliations
- PMID: 34173604
- PMCID: PMC7677076
- DOI: 10.1016/j.lanwpc.2020.100056
Abstract
Background: Countries with a high incidence of coronavirus 2019 (COVID-19) reported reduced hospitalisations for acute coronary syndromes (ACS) during the pandemic. This study describes the impact of a nationwide lockdown on ACS hospitalisations in New Zealand (NZ), a country with a low incidence of COVID-19.
Methods: All patients admitted to a NZ Hospital with ACS who underwent coronary angiography in the All NZ ACS Quality Improvement registry during the lockdown (23 March - 26 April 2020) were compared with equivalent weeks in 2015-2019. Ambulance attendances and regional community troponin-I testing were compared for lockdown and non-lockdown (1 July 2019 to 16 February 2020) periods.
Findings: Hospitalisation for ACS was lower during the 5-week lockdown (105 vs. 146 per-week, rate ratio 0•72 [95% CI 0•61-0•83], p = 0.003). This was explained by fewer admissions for non-ST-segment elevation ACS (NSTE-ACS; p = 0•002) but not ST-segment elevation myocardial infarction (STEMI; p = 0•31). Patient characteristics and in-hospital mortality were similar. For STEMI, door-to-balloon times were similar (70 vs. 72 min, p = 0•52). For NSTE-ACS, there was an increase in percutaneous revascularisation (59% vs. 49%, p<0•001) and reduction in surgical revascularisation (9% vs. 15%, p = 0•005). There were fewer ambulance attendances for cardiac arrests (98 vs. 110 per-week, p = 0•04) but no difference for suspected ACS (408 vs. 420 per-week, p = 0•44). Community troponin testing was lower throughout the lockdown (182 vs. 394 per-week, p<0•001).
Interpretation: Despite the low incidence of COVID-19, there was a nationwide decrease in ACS hospitalisations during the lockdown. These findings have important implications for future pandemic planning.
Funding: The ANZACS-QI registry receives funding from the New Zealand Ministry of Health.