Significant drop in ACS admissions
The COVID-19 pandemic has seen a decline in patients admitted with acute coronary syndromes, a report in the Lancet finds.
Reduced admissions with acute coronary syndromes on an unprecedented scale, were reported by a very distinguished group of authors this week in the Lancet. This national data collection exercise demonstrated a 23% reduction in STEMI and a 42% reduction in NSTEMI. Even within hospitals, practice has changed with a drop of more than 75% in cardiac surgery. Although there is some recovery over time, up until the end of May numbers remain significantly reduced compared with 2019. There was no difference in early mortality for those admitted, however, we cannot know the effect this will have in the entire population. Extensive data regarding early and interventional treatments for acute coronary syndromes makes it is almost inevitable that the result will be a higher rate of late presentations, late complications and death at home without intervention. This would be supported by the rise of around 20% in deaths at home noted elsewhere in the same period.
It has never been more important to emphasise that UK cardiology is open for business and patients with symptoms should continue to present rapidly. As a society we need to make this case to the public, to government and to our own organisation; these need to be properly configured to avoid obstructions to care in this new era.
Weekly admissions to acute National Health Service hospital trusts in England with an acute coronary syndrome, by type (Source: The Lancet)