Trends in major adverse cardiac events and healthcare utilization during the COVID-19 pandemic in Alberta, Canada.


Journal

CJC open
ISSN: 2589-790X
Titre abrégé: CJC Open
Pays: United States
ID NLM: 101763635

Informations de publication

Date de publication:
22 Jun 2023
Historique:
received: 22 02 2023
revised: 31 05 2023
accepted: 19 06 2023
medline: 27 6 2023
pubmed: 27 6 2023
entrez: 27 6 2023
Statut: aheadofprint

Résumé

Atherosclerotic cardiovascular disease (ASCVD) is a leading cause of morbidity and mortality in Canada. The COVID-19 pandemic altered the usual care of ambulatory and acute cardiac patients. This study aimed to describe ASCVD-related clinical outcomes and healthcare resource utilization (HCRU) patterns during the coronavirus disease 2019 (COVID-19) pandemic in Alberta, Canada, relative to the three preceding years. A repeated cross-sectional study design was conducted over three-month periods using administrative health data between March 15, 2017, and March 14, 2021. ASCVD-related clinical outcomes included major adverse cardiovascular events (MACE) endpoints. HCRU was assessed through general practitioner and other healthcare professional visits (including telehealth claims) for ASCVD events, emergency department visits, ASCVD diagnostic imaging tests, laboratory tests, and hospital length of stay. Relative to the control year period (March to June 2019) ASCVD-related events (i.e., hospitalizations, emergency department (ED) visits and physician office visits) declined by 23% during the three-months COVID-19 period (March to June 2020). Acute declines were not sustained following June 2020. In contrast, in-patient mortality rates involving a primary MACE endpoint increased from March to June 2020 COVID-19 period. This study demonstrates the COVID-19 pandemic and corresponding public health restrictions impacted ASCVD-related care. While many clinical outcomes returned to pre-pandemic levels at the end of the observation period, our results suggest that patients' HCRU declined, which could lead to further CV events and mortality. Understanding the impact of COVID-19 restrictions on ASCVD-related care may help improve healthcare resiliency.

Sections du résumé

Background UNASSIGNED
Atherosclerotic cardiovascular disease (ASCVD) is a leading cause of morbidity and mortality in Canada. The COVID-19 pandemic altered the usual care of ambulatory and acute cardiac patients. This study aimed to describe ASCVD-related clinical outcomes and healthcare resource utilization (HCRU) patterns during the coronavirus disease 2019 (COVID-19) pandemic in Alberta, Canada, relative to the three preceding years.
Methods UNASSIGNED
A repeated cross-sectional study design was conducted over three-month periods using administrative health data between March 15, 2017, and March 14, 2021. ASCVD-related clinical outcomes included major adverse cardiovascular events (MACE) endpoints. HCRU was assessed through general practitioner and other healthcare professional visits (including telehealth claims) for ASCVD events, emergency department visits, ASCVD diagnostic imaging tests, laboratory tests, and hospital length of stay.
Results UNASSIGNED
Relative to the control year period (March to June 2019) ASCVD-related events (i.e., hospitalizations, emergency department (ED) visits and physician office visits) declined by 23% during the three-months COVID-19 period (March to June 2020). Acute declines were not sustained following June 2020. In contrast, in-patient mortality rates involving a primary MACE endpoint increased from March to June 2020 COVID-19 period.
Conclusions UNASSIGNED
This study demonstrates the COVID-19 pandemic and corresponding public health restrictions impacted ASCVD-related care. While many clinical outcomes returned to pre-pandemic levels at the end of the observation period, our results suggest that patients' HCRU declined, which could lead to further CV events and mortality. Understanding the impact of COVID-19 restrictions on ASCVD-related care may help improve healthcare resiliency.

Identifiants

pubmed: 37366514
doi: 10.1016/j.cjco.2023.06.004
pii: S2589-790X(23)00147-6
pmc: PMC10286559
doi:

Types de publication

Journal Article

Langues

eng

Informations de copyright

© 2023 Published by Elsevier Inc. on behalf of the Canadian Cardiovascular Society.

Références

CMAJ. 2014 Feb 18;186(3):180-7
pubmed: 24366893
J Clin Med. 2022 Mar 22;11(7):
pubmed: 35407360
Can J Cardiol. 2017 Mar;33(3):378-384
pubmed: 28129964
Diabetes Metab Syndr. 2020 Sep - Oct;14(5):767-771
pubmed: 32521463
J Am Coll Cardiol. 2021 Jan 19;77(2):173-185
pubmed: 33446311
Pharmacoecon Open. 2018 Dec;2(4):433-442
pubmed: 29623635
J Am Coll Cardiol. 2018 Jun 12;71(23):2680-2690
pubmed: 29880129
Can J Cardiol. 2020 Jul;36(7):1068-1080
pubmed: 32425328
PLoS One. 2021 Jun 1;16(6):e0252441
pubmed: 34061888
Eur J Endocrinol. 2020 Aug;183(2):G57-G65
pubmed: 32396134
Can J Cardiol. 2021 Oct;37(10):1547-1554
pubmed: 34600793
Can J Cardiol. 2020 Jun;36(6):952-955
pubmed: 32299752
Arch Med Res. 2015 Jul;46(5):328-38
pubmed: 26135634
J Thorac Cardiovasc Surg. 2021 Sep;162(3):893-903.e4
pubmed: 32768300
JAMA. 2020 Mar 17;323(11):1061-1069
pubmed: 32031570
Clin Cardiol. 2021 Nov;44(11):1613-1620
pubmed: 34585767
JAMA. 2010 May 12;303(18):1841-7
pubmed: 20460623
J Am Coll Cardiol. 2022 Aug 9;80(6):631-640
pubmed: 35926937
Circulation. 2017 Mar 7;135(10):e146-e603
pubmed: 28122885
Nat Rev Cardiol. 2020 May;17(5):259-260
pubmed: 32139904

Auteurs

Erin S Mackinnon (ES)

Amgen Canada Inc., Mississauga, Ontario, Canada.

Todd Anderson (T)

University of Calgary, Calgary, Alberta, Canada.

Paulo Raggi (P)

University of Alberta, Edmonton, Alberta, Canada.

Jean Gregoire (J)

Montreal Heart Institute, Montreal, Quebec, Canada.

Rajvi J Wani (RJ)

Amgen Canada Inc., Mississauga, Ontario, Canada.

Millicent S Packalen (MS)

Amgen Canada Inc., Mississauga, Ontario, Canada.

Erin Graves (E)

Medlior Health Outcomes Research Ltd., Calgary, Alberta, Canada.

Paul Ekwaru (P)

Medlior Health Outcomes Research Ltd., Calgary, Alberta, Canada.

Suzanne McMullen (S)

Medlior Health Outcomes Research Ltd., Calgary, Alberta, Canada.

Shaun G Goodman (SG)

St. Michaels Hospital, Toronto, Ontario, and Canadian VIGOUR Centre, University of Alberta, Edmonton, Alberta, Canada.

Classifications MeSH