The impact of a national COVID-19 lockdown on acute coronary syndrome hospitalisations in New Zealand (ANZACS-QI 55)

The Lancet Regional Health. Western Pacific

Charmaine Flynn¹  Andrew J. Kerr²  John M. Elliott³  Tony Smith⁴  Ralph AH. Stewart⁵  John Edmond⁶  Philip D. Adamson⁷  Verity F. Todd⁸  Nick Fisher⁹  Gerry Devlin^1,10  Michael JA. Williams^1,11  Mark WI. Webster^1,11  Campbell V. Kyle^1,11  Martin K. Stiles^1,12  Yi-Wen (Becky) Liao^1,13  Maxine Rhodes^1,14  Seif El-Jack^1,15  Tony Scott^1,16  Mildred Lee^1,17  Daniel ZL. Chan^1,18  Bridget Dicker^1,18  Jithendra B. Somaratne^1,18  Andrew H. Swain^1,19  Harvey D. White^1,19 

[1] British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, United Kingdom;Corresponding author at: Department of Cardiology, Middlemore Hospital, Private Bag 93311, Otahuhu, Auckland 1640, New Zealand.;Department of Biochemistry, Labtests New Zealand, Auckland, New Zealand;Department of Cardiology, Christchurch Hospital, Christchurch, New Zealand;Department of Cardiology, Middlemore Hospital, Private Bag 93311, Otahuhu, Auckland 1640, New Zealand;Department of Paramedicine, Auckland University of Technology, Auckland, New Zealand;School of Population Health, University of Auckland, Auckland, New Zealand;Tauranga Hospital, Tauranga, New Zealand;Christchurch Heart Institute, University of Otago, Christchurch, New Zealand;Clinical Audit and Research, St John New Zealand, Auckland, New Zealand;Department of Cardiology, Middlemore Hospital, Private Bag 93311, Otahuhu, Auckland 1640, New Zealand;Department of Cardiology, Nelson Hospital, Nelson, New Zealand;Department of Cardiology, Southern District Health Board, Dunedin, New Zealand;Department of Cardiology, Waitemata District Health Board, Auckland, New Zealand;Department of Chemical Pathology, LabPlus, Auckland City Hospital, Auckland, New Zealand;Department of Medicine, University of Otago, Christchurch, New Zealand;Gisborne Hospital, Gisborne, New Zealand;Greenlane Cardiovascular Service, Auckland City Hospital, Auckland, New Zealand;The National Institute for Health Innovation, University of Auckland, Auckland New Zealand;

关键词: Acute coronary syndrome;    Coronavirus 2019;   

DOI  :  

来源: DOAJ

【 摘 要 】

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.

【 授权许可】

Unknown