Key result
The COVID-19 pandemic significantly reduced the rates of elective and emergency PCIs in Japan to 83.0% and 92.8% of historical volumes, respectively, without affecting in-hospital mortality for emergency cases.
Why the study?
Although declines in cardiovascular diseases were reported during the first surge of COVID-19, the medium-term impact of repeating surges on the practice of PCIs remained uninvestigated.
Does the COVID-19 pandemic reduce the rates of percutaneous coronary interventions in Japan?
Observational (n=86,196)
Yes
Does the COVID-19 pandemic reduce the rates of percutaneous coronary interventions in Japan?
The COVID-19 pandemic caused a significant medium-term reduction in PCI volumes in Japan, particularly for elective procedures during the first surge, without adversely affecting in-hospital mortality for emergency PCIs.
AIMS: Declines in cardiovascular diseases during the first surge of coronavirus disease 2019 (COVID-19) have been reported. With the repeating surges of COVID-19, we aim to investigate the medium-term impact of the COVID-19 pandemic on the practice of percutaneous coronary interventions (PCIs). METHODS: We performed a descriptive analysis of rates of PCIs, utilizing administrative data in Japan. Changes in the proportion of severe cases and in-hospital mortality since the start of the COVID-19 pandemic were investigated using interrupted time series (ITS) analyses. RESULTS: From April 2018 to February 2021, 38,696 and 28,585 cases of elective and emergency PCIs, respectively, were identified. The rates of PCIs decreased during the first and third COVID-19 surges. The ratios of monthly rates of elective PCIs to that in the corresponding months during the previous 2 years were 50.3% in May 2020 and 76.1% in January 2021. The decrease in rates of emergency PCIs was smaller than that of elective PCIs. The ITS analyses did not identify any significant changes in the proportion of severe cases and in-hospital mortality. CONCLUSIONS: We found that the impacts of COVID-19 on PCIs were larger in the first surge than in the subsequent and larger in the elective than in the emergency; this continued over the medium-term. During the COVID-19 pandemic, in-hospital mortality of cases undertaking emergency PCIs did not change.
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Watanabe et al. (2021) conducted an observational in Patients undergoing percutaneous coronary interventions (PCIs) (n=86,196). COVID-19 pandemic surges vs. Pre-pandemic period (April 2018 to March 2020) was evaluated on Accumulated rate ratio of elective PCIs from April 2020 to February 2021 compared to the corresponding months in the previous 2 years (RR 0.83, 95% CI 0.811-0.849). The COVID-19 pandemic significantly reduced the rates of elective and emergency PCIs in Japan to 83.0% and 92.8% of historical volumes, respectively, without affecting in-hospital mortality for emergency cases.
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