Informação da revista
Vol. 40. Núm. 3.
Páginas 251 (Março 2021)
Partilhar
Partilhar
Baixar PDF
Mais opções do artigo
Vol. 40. Núm. 3.
Páginas 251 (Março 2021)
Letter to the Editor
Open Access
The fall in acute coronary syndrome admissions during the COVID-19 Portuguese lockdown
A queda das admissões por síndrome coronária aguda durante o estado de emergência português pela COVID-19
Visitas
...
Daniel Candeias Faria
Autor para correspondência
danielfaria8@gmail.com

Corresponding author.
, Miguel Borges Santos, Pedro Farto e Abreu
Serviço de Cardiologia, Hospital Professor Doutor Fernando Fonseca, Amadora, Portugal
Informação do artigo
Texto Completo
Bibliografia
Baixar PDF
Estatísticas
Texto Completo
To the Editor:

Acute coronary syndromes (ACS), and in particular acute ST-segment elevation myocardial infarction, have a high rate of complications and associated mortality.1,2 Early access to percutaneous coronary intervention (PCI) has significant prognostic implications and is currently recommended in society guidelines worldwide.

In response to the SARS-CoV-2/COVID-19 pandemic, healthcare institutions have organized their facilities to guarantee timely access to coronary angiography and PCI for ACS patients. However, the number of reported ACS admissions during the lockdown decreased.3 This is of particular interest, given the positive association between ACS and viral disease seasonality,4 and also due to recent evidence showing increased thrombogenicity in COVID-19 patients.5

A recent report from 71 Spanish centers showed reductions in interventional cardiology activity, including a 40% reduction in PCI in ST elevation myocardial infarction.6 Importantly, Portuguese nationwide data analysis has systematically shown relative excess in mortality given the number of positive COVID-19 cases. A possible explanation could be related to an increase in the number of untreated ACS patients who did not seek medical care or call the emergency hotline during the lockdown.

We performed descriptive ACS-related data analysis at Hospital Professor Doutor Fernando Fonseca, which has an area of influence including approximately 600 000 patients. In the first 30 days after the lockdown in Portugal, the number of ACS admitted to our hospital, and who underwent a coronary angiography (n=30), was reduced by 49.7% compared with the mean between 2016-2018 over the same time period (n=60.3).

Given the global nature of the current situation, we hypothesize that similar findings will be found at other Portuguese centers. Going forward, the Portuguese Society of Cardiology, the Portuguese Association of Cardiovascular Interventions and the Stent - Save a Life Initiative, alongside health authorities and media should publicly promote that patients with ACS-compatible symptoms should avoid confinement and seek urgent medical attention.

Conflicts of interest

The authors have no conflicts of interest to declare.

References
[1]
S.D. Kristensen, K.G. Laut, J. Fajadet, et al.
Reperfusion therapy for ST elevation acute myocardial infarction 2010/2011: current status in 37 ESC countries.
Eur Heart J, 35 (2014), pp. 1957-1970
[2]
F. Pedersen, V. Butrymovich, H. Kelbæk, et al.
Short- and long-term cause of death in patients treated with primary PCI for STEMI.
J Am Coll Cardiol, 64 (2014), pp. 2101-2108
[3]
Tam C-CF, K.-S. Cheung, S. Lam, et al.
Impact of coronavirus disease 2019 (COVID-19) outbreak on ST-segment – elevation myocardial infarction care in Hong Kong, China.
Circ Cardiovasc Qual Outcomes, (2020),
[4]
T. Thom, N. Haase, W. Rosamond, et al.
Heart disease and stroke statistics—2006 update.
[5]
C. Magro, J.J. Mulvey, D. Berlin, et al.
Complement associated microvascular injury and thrombosis in the pathogenesis of severe COVID-19 infection: a report of five cases.
[6]
O. Rodríguez-Leor, B. Cid-Álvarez, S. Ojeda, et al.
Impacto de la pandemia de COVID-19 sobre la actividad asistencial en cardiología intervencionista en España.
REC Interv Cardiol, (2020),
Copyright © 2020. Sociedade Portuguesa de Cardiologia
Idiomas
Revista Portuguesa de Cardiologia

Receba a nossa Newsletter

Opções de artigo
Ferramentas
en pt

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos

Ao assinalar que é «Profissional de Saúde», declara conhecer e aceitar que a responsável pelo tratamento dos dados pessoais dos utilizadores da página de internet da Revista Portuguesa de Cardiologia (RPC), é esta entidade, com sede no Campo Grande, n.º 28, 13.º, 1700-093 Lisboa, com os telefones 217 970 685 e 217 817 630, fax 217 931 095 e com o endereço de correio eletrónico revista@spc.pt. Declaro para todos os fins, que assumo inteira responsabilidade pela veracidade e exatidão da afirmação aqui fornecida.