Impact of the COVID-19 pandemic on acute coronary syndrome hospital admission and management in Slovenia

Furlan, Tjaša (author), Bijec, Janez (author), Došenović Bonča, Petra (author), Ograjenšek, Irena (author), Jug, Borut (author)

Aims We evaluated the effects of the COVID-19 pandemic on hospital admission and quality of care for acute coronary syndrome. Methods and results Data for all patients admitted to hospital care for acute coronary syndromes in Slovenia (nationwide cohort) between 2014 and 2021 were obtained by merging the national hospital database, national medicines reimbursement database and population mortality registry using unique identifying numbers. Using interrupted time series analysis, we assessed the impact of the COVID-19 pandemic on hospital admission rates and quality of care (in-hospital and 30-day mortality, reperfusion and secondary preventive medication uptake). Data were fitted to segmented regression models with March 2020 as the breakpoint. Data on 21 001 patients were included (7057 ST-elevation myocardial infarction (STEMI), 7649 non- ST elevation myocardial infarction (NSTEMI) and 6295 unstable angina). Hospital admissions for STEMI remained stable (92 patients; +1 patient per month, p=0.783), whereas the pandemic was associated with a significant reduction in NSTEMI (81 patients; -21 patients per month, p=0.015) and unstable angina admissions (47 patients; -28 patients per month, p=0.025). In patients with STEMI, the pandemic did not affect reperfusion rates (0.29%, (95% CI) -1.5% to 2.1%, p=0.755) or in-hospital mortality (0.1%, (95% CI) -0.9% to 1.1%, p=0.815), but was associated with a significant negative trend for secondary preventive medication uptake (-0.12%, (95% CI) -0.23% to -0.01%, p=0.034). Conclusion In Slovenia, hospital admissions for STEMI remained stable throughout the COVID-19 pandemic, but NSTEMI and unstable angina admissions dropped significantly. While mortality and reperfusion rates were not affected, the pandemic was associated with a continual negative time trend for the uptake of secondary preventive medication.

• Language: English
• Keywords: pandemic, hospitals, management, Slovenia
• Work type: Article
• Typology: 1.01 - Original Scientific Article
• Organization: FE - Faculty of Electrical Engineering; EF - School of Economics and Business
• Publication status: Published
• Publication version: Version of Record
• Year: 2023
• Number of pages: 7 str.
• Numbering: Vol. 10, iss. 2, article no. e002440
• PID: 20.500.12556/RUL-159804
• UDC: 614
• ISSN on article: 2053-3624
• DOI: 10.1136/openhrt-2023-002440
• COBISS.SI-ID: 173356291
• Publication date in RUL: 25.07.2024

Record is a part of a journal

• Title: Open heart
• Publisher: BMJ Publishing Group Ltd
• ISSN: 2053-3624
• COBISS.SI-ID: 523322905

Licences

• License: CC BY 4.0, Creative Commons Attribution 4.0 International
• Link: http://creativecommons.org/licenses/by/4.0/
• Description: This is the standard Creative Commons license that gives others maximum freedom to do what they want with the work as long as they credit the author.

Secondary language

• Language: Slovenian
• Keywords: pandemija, bolnišnice, management, Slovenija

Projects

• Funder: ARIS - Slovenian Research and Innovation Agency
• Project number: V3-2104
• Name: Sekundarna preventiva in kakovosti oskrbe po srčnem infarktu v slovenskih bolnišnicah ter analiza vpliva epidemije covid-19 na obravnavo aterosklerotične bolezni