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The impact of a national COVID-19 lockdown on acute coronary syndrome hospitalisations in New Zealand (ANZACS-QI 55). | LitMetric
Background : Countries with a high incidence of coronavirus 2019 (COVID-19) reported reduced hospitalisations for acute coronary syndromes (ACS) during the pandemic. This study describes the impact of a nationwide lockdown on ACS hospitalisations in New Zealand (NZ), a country with a low incidence of COVID-19.Methods : All patients admitted to a NZ Hospital with ACS who underwent coronary angiography in the All NZ ACS Quality Improvement registry during the lockdown (23 March - 26 April 2020) were compared with equivalent weeks in 2015-2019. Ambulance attendances and regional community troponin-I testing were compared for lockdown and non-lockdown (1 July 2019 to 16 February 2020) periods.Findings : Hospitalisation for ACS was lower during the 5-week lockdown (105 vs. 146 per-week, rate ratio 0•72 [95% CI 0•61-0•83], = 0.003). This was explained by fewer admissions for non-ST-segment elevation ACS (NSTE-ACS; = 0•002) but not ST-segment elevation myocardial infarction (STEMI; = 0•31). Patient characteristics and in-hospital mortality were similar. For STEMI, door-to-balloon times were similar (70 vs. 72 min, = 0•52). For NSTE-ACS, there was an increase in percutaneous revascularisation (59% vs. 49%, <0•001) and reduction in surgical revascularisation (9% vs. 15%, = 0•005). There were fewer ambulance attendances for cardiac arrests (98 vs. 110 per-week, = 0•04) but no difference for suspected ACS (408 vs. 420 per-week, = 0•44). Community troponin testing was lower throughout the lockdown (182 vs. 394 per-week, <0•001).Interpretation : Despite the low incidence of COVID-19, there was a nationwide decrease in ACS hospitalisations during the lockdown. These findings have important implications for future pandemic planning.Funding : The ANZACS-QI registry receives funding from the New Zealand Ministry of Health.
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