Key result
The COVID-19 pandemic significantly reduced the selection of invasive treatment strategies from 51.9 to 24.8 patients per month in favor of conservative management.
Why the study?
The impact of the COVID-19 pandemic on Heart Team functioning and treatment strategy decision-making remained to be investigated.
Does the COVID-19 pandemic reduce the frequency of Heart Team meetings and the selection of invasive procedures in patients with severe coronary artery disease or valvular heart disease?
Cohort (n=4,183)
No
Does the COVID-19 pandemic reduce the frequency of Heart Team meetings and the selection of invasive procedures in patients with severe coronary artery disease or valvular heart disease?
The COVID-19 pandemic significantly reduced the frequency of Heart Team meetings and the number of consulted patients, leading to a shift from invasive procedures to conservative management for severe coronary and valvular heart disease.
Pandemic-linked drops in Heart Team activity and invasive choices may reflect constraints; leaves open outcome effects in complex CAD/VHD.
Introduction The Heart Team (HT) as a group of experienced specialists is responsible for optimal decision-making for high-risk cardiac patients. The aim of this study was to investigate the impact of the COVID-19 pandemic on HT functioning. Methods In this retrospective, single-center study, we evaluated the cooperation of HT in terms of the frequency of meetings, the number of consulted patients, and the trends in choosing the optimal treatment strategies for complex individuals with severe coronary artery disease (CAD) or valvular heart disease (VHD) before and during the COVID-19 pandemic in Poland. Results From 2016 to May 2022, 301 HT meetings were held, and a total of 4,183 patients with severe CAD (2,060 patients) or severe VHD (2,123 patients) were presented. A significant decrease in the number of HT meetings and consulted patients (2019: 49 and 823 vs. 2020: 44 and 542 and 2021: 45 and 611, respectively, P < 0.001) as well as changes in treatment strategies—increase of conservative, reduction of invasive (2019: 16.7 and 51.9 patients/month vs. 2020: 20.4 and 24.8 patients/month and 2021:19.3 and 31.6 patients/month, respectively, P < 0.001)—were demonstrated with the spread of the COVID-19 pandemic. As the pandemic slowly receded, the observed changes began to return to the pre-pandemic trends. Conclusions The COVID-19 pandemic resulted in a decrease in the number of HT meetings and consulted patients and significant reduction of invasive procedures in favor of conservative management. Further studies should be aimed to evaluate the long-term implications of this phenomenon.
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Jonik et al. (2023) conducted a cohort in Severe coronary artery disease or valvular heart disease (n=4,183). COVID-19 pandemic vs. Pre-pandemic period (2019) was evaluated on Invasive treatment strategy selection (patients/month) (p=<0.001). The COVID-19 pandemic significantly reduced the selection of invasive treatment strategies from 51.9 to 24.8 patients per month in favor of conservative management.
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