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Deferral of non-emergency cardiac interventions is associated with increased emergency hospitalizations up to 24 months post-procedure

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Název: Deferral of non-emergency cardiac interventions is associated with increased emergency hospitalizations up to 24 months post-procedure
Autoři: Stefanie Andreß, Dominik Felbel, Dominik Buckert, Wolfgang Rottbauer, Armin Imhof, Tilman Stephan
Zdroj: Clin Res Cardiol
Informace o vydavateli: Springer Science and Business Media LLC, 2024.
Rok vydání: 2024
Témata: Male, Aged, 80 and over, Original Paper, Cardiac Catheterization, Time Factors, COVID-19, Middle Aged, Peptide Fragments, Time-to-Treatment, Hospitalization, 03 medical and health sciences, 0302 clinical medicine, Natriuretic Peptide, Brain, Humans, Female, Female [MeSH], Aged, 80 and over [MeSH], Heart failure, Aged [MeSH], Humans [MeSH], Natriuretic Peptide, Brain/blood [MeSH], Cardiac Catheterization/methods [MeSH], Emergency hospitalizations, Retrospective Studies [MeSH], Middle Aged [MeSH], Time-to-Treatment [MeSH], Hospitalization/statistics, Time Factors [MeSH], Epidemiology, Male [MeSH], COVID-19 pandemic, Peptide Fragments/blood [MeSH], COVID-19/epidemiology [MeSH], Deferral, Retrospective Studies, Aged
Popis: Background Patients, whose non-emergency cardiac procedure was postponed during the COVID-19 pandemic, have shown signs of disease progression in the short term. Data on the long-term effects are currently lacking. Aim To assess outcomes through 3 years following deferral. Methods This retrospective, single-center analysis includes consecutive patients whose non-emergency cardiovascular intervention was postponed during the first COVID-19-related lockdown (March 19 to April 30, 2020). Outcomes over 36 months post-procedure were analyzed and compared to a seasonal control group undergoing non-emergency intervention in 2019 as scheduled (n = 214). The primary endpoint was a composite of emergency cardiovascular hospitalization and death. Additionally, NT-proBNP levels were analyzed. Results The combined endpoint occurred in 60 of 178 patients (33.7%) whose non-emergency transcatheter heart valve intervention, rhythmological procedure, or left heart catheterization was postponed. Primary endpoint events did not occur more frequently in the study group during the 36-month follow-up (p = 0.402), but within the first 24 months post-procedure (HR 1.77, 95% CI 1.20–2.60, p = 0.003). Deferred patients affected by an event in the postprocedural 24 months had significantly higher NT-proBNP levels at the time of intervention (p p = 0.003, optimum cut-off 808.5 pg/ml, sensitivity 84.2%, specificity 65.8%) and thereafter (p Conclusion Deferral of non-emergency cardiovascular interventions is associated with poor outcomes up to 24 months post-procedure. Adverse effects affect patients who develop signs of acute heart failure, as indicated by NT-proBNP, prior to treatment. These findings could help improve resource allocation in times of limited capacity. Graphical Abstract
Druh dokumentu: Article
Other literature type
Jazyk: English
ISSN: 1861-0692
1861-0684
DOI: 10.1007/s00392-024-02380-y
Přístupová URL adresa: https://pubmed.ncbi.nlm.nih.gov/38446147
https://repository.publisso.de/resource/frl:6497023
Rights: CC BY
Přístupové číslo: edsair.doi.dedup.....7c714665d806998549078c8c67e04597
Databáze: OpenAIRE
Popis
Abstrakt:Background Patients, whose non-emergency cardiac procedure was postponed during the COVID-19 pandemic, have shown signs of disease progression in the short term. Data on the long-term effects are currently lacking. Aim To assess outcomes through 3 years following deferral. Methods This retrospective, single-center analysis includes consecutive patients whose non-emergency cardiovascular intervention was postponed during the first COVID-19-related lockdown (March 19 to April 30, 2020). Outcomes over 36 months post-procedure were analyzed and compared to a seasonal control group undergoing non-emergency intervention in 2019 as scheduled (n = 214). The primary endpoint was a composite of emergency cardiovascular hospitalization and death. Additionally, NT-proBNP levels were analyzed. Results The combined endpoint occurred in 60 of 178 patients (33.7%) whose non-emergency transcatheter heart valve intervention, rhythmological procedure, or left heart catheterization was postponed. Primary endpoint events did not occur more frequently in the study group during the 36-month follow-up (p = 0.402), but within the first 24 months post-procedure (HR 1.77, 95% CI 1.20–2.60, p = 0.003). Deferred patients affected by an event in the postprocedural 24 months had significantly higher NT-proBNP levels at the time of intervention (p p = 0.003, optimum cut-off 808.5 pg/ml, sensitivity 84.2%, specificity 65.8%) and thereafter (p Conclusion Deferral of non-emergency cardiovascular interventions is associated with poor outcomes up to 24 months post-procedure. Adverse effects affect patients who develop signs of acute heart failure, as indicated by NT-proBNP, prior to treatment. These findings could help improve resource allocation in times of limited capacity. Graphical Abstract
ISSN:18610692
18610684
DOI:10.1007/s00392-024-02380-y