Changes in percutaneous coronary intervention practice in Japan during the COVID-19 outbreak: LIFE Study

Megumi Maeda; Haruhisa Fukuda; Kosuke Kiyohara; Ryusuke Miki; Tetsuhisa Kitamura

doi:10.1002/ams2.638

Changes in percutaneous coronary intervention practice in Japan during the COVID-19 outbreak: LIFE Study

Acute Med Surg. 2021 Mar 11;8(1):e638. doi: 10.1002/ams2.638. eCollection 2021 Jan-Dec.

Authors

Megumi Maeda¹, Haruhisa Fukuda^{1

2}, Kosuke Kiyohara³, Ryusuke Miki⁴, Tetsuhisa Kitamura⁵

Affiliations

¹ Department of Health Care Administration and Management Graduate School of Medical Sciences Kyushu University Fukuoka Japan.
² Center for Cohort Studies Graduate School of Medical Sciences Kyushu University Fukuoka Japan.
³ Department of Food Science Faculty of Home Economics Otsuma Women's University Tokyo Japan.
⁴ Public Health Planning Division Public Health Bureau Kobe City Government Kobe Japan.
⁵ Division of Environmental Medicine and Population Sciences Department of Social and Environmental Medicine Graduate School of Medicine Osaka University Suita Japan.

Abstract

Aim: The global outbreak of coronavirus disease (COVID-19) has had widespread effects on clinical practice, and is reportedly associated with reduced percutaneous coronary intervention (PCI) rates in the US and Italy. This study aimed to ascertain the influence of the COVID-19 outbreak on PCI practice in Japan.

Methods: In a retrospective analysis of claims data from National Health Insurance and Later-Stage Elderly Healthcare System enrollees in Kobe City, Japan, we examined the changes in PCI incidence before and during the COVID-19 outbreak. Percutaneous coronary intervention incidence during the COVID-19 outbreak in 2020 was compared with that of the same (pre-outbreak) period in 2019 using a Poisson regression analysis with the monthly number of PCIs as the dependent variable.

Results: A total of 639 patients underwent PCI in Kobe City between February and May 2020. The results showed a 19% reduction in all PCI procedures during the outbreak relative to the pre-outbreak period (P = 0.001). There were no significant changes in non-elective PCIs for acute coronary syndrome (ACS) cases, but a 25% reduction in elective PCIs for non-ACS cases (P < 0.001).

Conclusions: The COVID-19 outbreak was associated with a decline in elective PCIs for non-ACS cases, but did not appear to influence non-elective PCIs for ACS cases in Japan.

Keywords: Acute coronary syndrome; COVID‐19 pandemic; elective surgical procedure; emergency medicine; percutaneous coronary intervention.