Implementation of Percutaneous Coronary Intervention During the COVID-19 Pandemic in Japan - Nationwide Survey Report of the Japanese Association of Cardiovascular Intervention and Therapeutics for Cardiovascular Disease

Circ J. 2020 Nov 25;84(12):2185-2189. doi: 10.1253/circj.CJ-20-0708. Epub 2020 Sep 19.

Abstract

Background: With the rapid spread of COVID-19, hospitals providing percutaneous coronary intervention (PCI) were placed in unique and unfamiliar circumstances. This study evaluated variations in the treatment of coronary artery disease according to time course of the COVID-19 pandemic in Japan.Methods and Results:The Japanese Association of Cardiovascular Intervention and Therapeutics performed serial surveys during the pandemic (in mid-April, late-April and mid-May 2020) with queries regarding the implementation of PCI. Hospitals were asked about their treatment strategies for elective PCI and emergency PCI for ST-elevation myocardial infarction (STEMI) and high-risk acute coronary syndrome (ACS) patients. Most hospitals opted to perform primary PCI in the usual manner at the beginning of the pandemic. As the pandemic progressed, hospitals in the 7 populated areas downgraded the performance of PCI for chronic coronary syndrome and high-risk ACS, but not for STEMI patients. After the state of emergency was lifted in most prefectures in mid-May, the rate of PCI gradually normalized. Screening tests, such as polymerase chain reaction and chest computed tomography, in ACS were frequently used.

Conclusions: The COVID-19 pandemic greatly affected PCI treatment in Japan. However, even in the most critical situations during the pandemic, most institutions continued to perform primary PCI normally for STEMI patients.

Keywords: COVID-19; Japan; Percutaneous coronary intervention; Survey.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Coronary Syndrome / diagnostic imaging
  • Acute Coronary Syndrome / therapy*
  • COVID-19*
  • Cardiologists / trends
  • Clinical Decision-Making
  • Coronary Artery Disease / diagnostic imaging
  • Coronary Artery Disease / therapy*
  • Health Care Surveys
  • Humans
  • Japan
  • Outcome and Process Assessment, Health Care / trends*
  • Pandemics*
  • Percutaneous Coronary Intervention / adverse effects
  • Percutaneous Coronary Intervention / trends*
  • Practice Patterns, Physicians' / trends
  • Risk Assessment
  • Risk Factors
  • ST Elevation Myocardial Infarction / diagnostic imaging
  • ST Elevation Myocardial Infarction / therapy*
  • Time Factors
  • Treatment Outcome