Trajectory of Cardiac Catheterization for Acute Coronary Syndrome and Out-of-Hospital Cardiac Arrest During the COVID-19 Pandemic

Pooja S Desai; Elias J Fanous; Weiyi Tan; James Lee; Tri Trinh; Asim M Rafique; Rushi V Parikh; Marcella Calfon Press

doi:10.14740/cr1149

Trajectory of Cardiac Catheterization for Acute Coronary Syndrome and Out-of-Hospital Cardiac Arrest During the COVID-19 Pandemic

Cardiol Res. 2021 Feb;12(1):47-50. doi: 10.14740/cr1149. Epub 2020 Dec 11.

Authors

Pooja S Desai¹, Elias J Fanous¹, Weiyi Tan^{2

3}, James Lee⁴, Tri Trinh⁴, Asim M Rafique², Rushi V Parikh², Marcella Calfon Press²

Affiliations

¹ Department of Internal Medicine, UCLA Medical Center, Los Angeles, CA, USA.
² Division of Interventional Cardiology, UCLA Medical Center, Los Angeles, CA, USA.
³ Division of Congenital Cardiology, UCLA Medical Center, Los Angeles, CA, USA.
⁴ UCLA Cardiology Group, Henry Mayo Hospital, Valencia, CA, USA.

PMID: 33447325
PMCID: PMC7781261
DOI: 10.14740/cr1149

Abstract

Background: We sought to investigate the trajectory of cardiac catheterizations for acute coronary syndrome (ACS) and out-of-hospital cardiac arrest (OHCA) during the pre-isolation (PI), strict-isolation (SI), and relaxed-isolation (RI) periods of the coronavirus disease 2019 (COVID-19) pandemic at three hospitals in Los Angeles, CA, USA.

Methods: A retrospective analysis was conducted on adult patients undergoing urgent or emergent cardiac catheterization for suspected ACS or OHCA between January 1, 2020 and June 2, 2020 at three hospitals in Los Angeles, CA, USA. We designated January 1, 2020 to March 17, 2020 as the PI COVID-19 period, March 18, 2020 to May 5, 2020 as the SI COVID-19 period, and May 6, 2020 to June 2, 2020 as the RI COVID-19 period.

Results: From PI to SI, there was a significant reduction in mean weekly cases of catheterizations for non-ST elevation myocardial infarction/unstable angina (NSTEMI/UA) (8.29 vs. 12.5, P = 0.019), with all other clinical categories trending downwards. From SI to RI, mean weekly cases of catheterizations for total ACS increased by 17%, NSTEMI/UA increased by 27%, and OHCA increased by 32%, demonstrating a "rebound effect".

Conclusions: Cardiac catheterizations for ACS and NSTEMI/UA exhibited a "rebound effect" once social isolation was relaxed.

Keywords: Acute coronary syndrome; COVID-19; Cardiac arrest; Cardiac catheterization.