eprintid: 10116853
rev_number: 17
eprint_status: archive
userid: 608
dir: disk0/10/11/68/53
datestamp: 2020-12-09 17:31:29
lastmod: 2021-12-06 00:57:55
status_changed: 2020-12-09 17:31:29
type: article
metadata_visibility: show
creators_name: Rashid, M
creators_name: Gale, CP
creators_name: Curzen, N
creators_name: Ludman, P
creators_name: De Belder, M
creators_name: Timmis, A
creators_name: Mohamed, MO
creators_name: Lüscher, TF
creators_name: Hains, J
creators_name: Wu, J
creators_name: Shoaib, A
creators_name: Kontopantelis, E
creators_name: Roebuck, C
creators_name: Denwood, T
creators_name: Deanfield, J
creators_name: Mamas, MA
title: Impact of Coronavirus Disease 2019 Pandemic on the Incidence and Management of Out‐of‐Hospital Cardiac Arrest in Patients Presenting With Acute Myocardial Infarction in England
ispublished: pub
divisions: UCL
divisions: B02
divisions: D14
divisions: GA4
keywords: acute myocardial infarction, coronavirus disease 2019, incidence, mortality, out‐of‐hospital cardiac arrest
note: Copyright © 2020 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.
This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
abstract: Background: Studies have reported significant reduction in acute myocardial infarction–related hospitalizations during the coronavirus disease 2019 (COVID‐19) pandemic. However, whether these trends are associated with increased incidence of out‐of‐hospital cardiac arrest (OHCA) in this population is unknown. /

Methods and Results: Acute myocardial infarction hospitalizations with OHCA during the COVID‐19 period (February 1–May 14, 2020) from the Myocardial Ischaemia National Audit Project and British Cardiovascular Intervention Society data sets were analyzed. Temporal trends were assessed using Poisson models with equivalent pre–COVID‐19 period (February 1–May 14, 2019) as reference. Acute myocardial infarction hospitalizations during COVID‐19 period were reduced by >50% (n=20 310 versus n=9325). OHCA was more prevalent during the COVID‐19 period compared with the pre–COVID‐19 period (5.6% versus 3.6%), with a 56% increase in the incidence of OHCA (incidence rate ratio, 1.56; 95% CI, 1.39–1.74). Patients experiencing OHCA during COVID‐19 period were likely to be older, likely to be women, likely to be of Asian ethnicity, and more likely to present with ST‐segment–elevation myocardial infarction. The overall rates of invasive coronary angiography (58.4% versus 71.6%; P<0.001) were significantly lower among the OHCA group during COVID‐19 period with increased time to reperfusion (mean, 2.1 versus 1.1 hours; P=0.05) in those with ST‐segment–elevation myocardial infarction. The adjusted in‐hospital mortality probability increased from 27.7% in February 2020 to 35.8% in May 2020 in the COVID‐19 group (P<.001). /

Conclusions: In this national cohort of hospitalized patients with acute myocardial infarction, we observed a significant increase in incidence of OHCA during COVID‐19 period paralleled with reduced access to guideline‐recommended care and increased in‐hospital mortality.
date: 2020-11-17
date_type: published
official_url: https://doi.org/10.1161/JAHA.120.018379
oa_status: green
full_text_type: pub
language: eng
primo: open
primo_central: open_green
verified: verified_manual
elements_id: 1822089
doi: 10.1161/JAHA.120.018379
lyricists_name: Deanfield, John
lyricists_id: JDEAN52
actors_name: Austen, Jennifer
actors_id: JAUST66
actors_role: owner
full_text_status: public
publication: Journal of the American Heart Association
volume: 9
number: 22
article_number: e018379
event_location: England
citation:        Rashid, M;    Gale, CP;    Curzen, N;    Ludman, P;    De Belder, M;    Timmis, A;    Mohamed, MO;                                     ... Mamas, MA; + view all <#>        Rashid, M;  Gale, CP;  Curzen, N;  Ludman, P;  De Belder, M;  Timmis, A;  Mohamed, MO;  Lüscher, TF;  Hains, J;  Wu, J;  Shoaib, A;  Kontopantelis, E;  Roebuck, C;  Denwood, T;  Deanfield, J;  Mamas, MA;   - view fewer <#>    (2020)    Impact of Coronavirus Disease 2019 Pandemic on the Incidence and Management of Out‐of‐Hospital Cardiac Arrest in Patients Presenting With Acute Myocardial Infarction in England.                   Journal of the American Heart Association , 9  (22)    , Article e018379.  10.1161/JAHA.120.018379 <https://doi.org/10.1161/JAHA.120.018379>.       Green open access   
 
document_url: https://discovery.ucl.ac.uk/id/eprint/10116853/1/JAHA.120.018379.pdf