Ascension Health System’s NCDR Analysis Finds Significant Decline in PCI to Treat STEMI During Pandemic

May 18, 2022—New findings from the Ascension Health System’s internal National Cardiovascular Data Registry (NCDR) analyze rates of percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI) in parallel with COVID-19 surges. Manoj Thangam, MD, Interventional Cardiologist at Ascension Texas Cardiovascular in Austin, Texas, is lead author of the study.

The analysis reveals that STEMI PCI cases dropped approximately 30% after the onset of the COVID-19 pandemic and have yet to recover to prepandemic levels. The data were presented at the Society for Cardiovascular Angiography & Interventions (SCAI) 2022 scientific sessions held May 19-22 in Atlanta, Georgia.

According to the SCAI press release, data were abstracted from the Ascension Health System’s internal NCDR CathPCI registry between March 2018 and June 2021 at 42 centers throughout the United States. Timing of the COVID-19 pandemic was assessed with county-level COVID prevalence.

Investigators performed a segmented regression analysis with a monthly interrupted time series utilizing a linear regression model to quantify expected STEMI PCIs before and after the COVID-19 onset. The predicted number of PCIs for STEMI was compared to predictions if COVID-19 had not occurred to evaluate differences in STEMI volumes.

As summarized in the SCAI press release, the investigators found that STEMI PCI trends increased until the pandemic declaration in March 2020, then a rapid decrease reached its nadir in April 2020 (first COVID surge). Thereafter, STEMI PCIs rose consistently until December 2020 (second COVID surge) when a less severe drop occurred.

The segmented regression showed 194 STEMI PCIs performed monthly (95% CI, 182-207; P < .001) with a month-to-month increase of two cases (95% CI, 1.0-2.8; P < .001). After the pandemic declaration, STEMI PCI decreased by 39 cases (95% CI, -60 to -18; P < .001) per month.

“Our network of PCI centers across the country gives us unique access to data that independent centers may not have,” commented Dr. Thangam in the SCAI press release. “Despite STEMI rates rising, we’ve never gotten back to our pre-COVID baseline which probably tells us there is still hesitation to come to the hospital despite having a major heart attack.”

The investigators noted a need for continued analysis of other potential consequences and ramifications of untreated STEMI patients that may result in increased mortality, heart failure, and morbidities in the aftermath of the COVID-19 pandemic, reported the SCAI press release.