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Open Access 23-05-2022 | Valvular Heart Disease | Original Paper

Deferral of non-emergency cardiac procedures is associated with increased early emergency cardiovascular hospitalizations

Authors: Stefanie Andreß, Tilman Stephan, Dominik Felbel, Alex Mack, Michael Baumhardt, Johannes Kersten, Dominik Buckert, Alexander Pott, Tillman Dahme, Wolfgang Rottbauer, Armin Imhof, Manuel Rattka

Published in: Clinical Research in Cardiology | Issue 10/2022

Abstract

Background

During the COVID-19 pandemic, in anticipation of a demand surge for high-care hospital beds, many hospitals postponed non-emergency interventions of cardiac patients.

Aim

The aim of this study was to assess the outcomes of cardiac patients whose non-emergency interventions had been deferred during the COVID-19 pandemic.

Methods

Patients whose non-emergency cardiac intervention had been cancelled between March 19th and April 30th, 2020 were included (study group). All patients were considered as deferrable according to current recommendations. Patients’ outcomes after 12 months were compared to a seasonal control group who underwent non-emergency interventions in 2019 as scheduled. The primary endpoint was a composite of emergency cardiovascular hospitalization and death. Secondary endpoints were levels of symptoms and cardiac biomarkers.

Results

Outcomes of 193 consecutive patients in the study group were assessed and compared to 216 controls. The primary endpoint occurred significantly more often in the study group (HR 2.42, 95%CI 1.63–3.61, p < 0.001). This was driven by an increase in hospitalizations. Subgroup analyses showed that especially patients with a deferred transcatheter heart valve intervention experienced early emergency hospitalization (HR 9.55, 95%CI 3.70–24.62, p < 0.001). These findings were accompanied by more pronounced symptoms and higher biomarker levels.

Conclusions

Deferral of non-emergency cardiac interventions to meet the higher demand for hospital beds during the COVID-19 crisis is associated with early emergency cardiovascular hospitalizations. Patients suffering from valvular heart disease especially constitute a vulnerable group. Consequently, our results suggest that current recommendations on the management of cardiovascular disease during the COVID-19 pandemic need revision.

Graphical abstract

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Title: Deferral of non-emergency cardiac procedures is associated with increased early emergency cardiovascular hospitalizations
Authors: Stefanie Andreß
Tilman Stephan
Dominik Felbel
Alex Mack
Michael Baumhardt
Johannes Kersten
Dominik Buckert
Alexander Pott
Tillman Dahme
Wolfgang Rottbauer
Armin Imhof
Manuel Rattka
Publication date: 23-05-2022
Publisher: Springer Berlin Heidelberg
Keywords: Valvular Heart Disease
COVID-19
Published in: Clinical Research in Cardiology / Issue 10/2022
Print ISSN: 1861-0684
Electronic ISSN: 1861-0692
DOI: https://doi.org/10.1007/s00392-022-02032-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Deferral of non-emergency cardiac procedures is associated with increased early emergency cardiovascular hospitalizations

Abstract

Background

Aim

Methods

Results

Conclusions

Graphical abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Aim

Methods

Results

Conclusions

Graphical abstract

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