IMR Press / RCM / Volume 23 / Issue 11 / DOI: 10.31083/j.rcm2311362
Open Access Original Research
Effect of COVID-19 Pandemic on Acute Coronary Syndrome Clinical Practice Patterns: Findings from a Multicenter Clinician Survey in China
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1 Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 200030 Shanghai, China
2 Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 100730 Beijing, China
3 Department of Cardiology, Guangdong Provincial Hospital of Chinese Medicine, 510120 Guangzhou, Guangdong, China
4 Department of Cardiology, Fuwai Yunnan Cardiovascular Hospital, 650102 Kunming, Yunnan, China
5 Department of Cardiology, Zhu Jiang Hospital of Southern Medical University, 510260 Guangzhou, Guangdong, China
6 Heart Center of Henan Provincial People's Hospital, Central China Fuwai Hospital, Central China Fuwai Hospital of Zhengzhou University, 451460 Zhengzhou, Henan, China
7 Department of Cardiology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, 310030 Hangzhou, Zhejiang, China
8 Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, 200030 Shanghai, China
9 Department of Cardiology, The Third Affiliated Hospital of Southern Medical University, 510630 Guangzhou, Guangdong, China
10 Department of Cardiology, University-Town Hospital of Chongqing Medical University, 401331 Chongqing, China
11 Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, 325035 Wenzhou, Zhejiang, China
12 Department of Cardiology, The Affiliated Hospital of Yangzhou University, 225003 Yangzhou, Jiangsu, China
*Correspondence: (Jun Pu); (Yan Yao)
Academic Editors: Manuel Martínez-Sellés and Alpo Vuorio
Rev. Cardiovasc. Med. 2022, 23(11), 362;
Submitted: 5 July 2022 | Revised: 18 August 2022 | Accepted: 31 August 2022 | Published: 25 October 2022
(This article belongs to the Special Issue Cardiovascular Health and COVID-19)
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.

Background: The coronavirus disease 2019 (COVID-19) pandemic has severely affected healthcare systems around the world. This study aimed to investigate the perceptions of cardiologists regarding how the COVID-19 pandemic has affected the clinical practice patterns for acute coronary syndrome (ACS). Methods: A multicenter clinician survey was sent to 300 cardiologists working in 22 provinces in China. The survey collected demographic information and inquired about their perceptions of how the COVID-19 pandemic has affected ACS clinical practice patterns. Results: The survey was completed by 211 (70.3%) cardiologists, 82.5% of whom were employed in tertiary hospitals, and 52.1% reported more than 10 years of clinical cardiology practice. Most respondents observed a reduction in ACS inpatients and outpatients in their hospitals during the pandemic. Only 29.9% of the respondents had access to a dedicated catheter room for the treatment of COVID-19-positive ACS patients. Most respondents stated that the COVID-19 pandemic had varying degrees of effect on the treatment of acute ST-segment elevation myocardial infarction (STEMI), acute non-ST-segment elevation myocardial infarction (NSTEMI), and unstable angina. Compared with the assumed non-pandemic period, in the designed clinical questions, the selection of coronary interventional therapy for STEMI, NSTEMI, and unstable angina during the COVID-19 pandemic was significantly decreased (all p < 0.05), and the selection of pharmacotherapy was increased (all p < 0.05). The selection of fibrinolytic therapy for STEMI during the pandemic was higher than in the assumed non-pandemic period (p < 0.05). Conclusions: The COVID-19 pandemic has profoundly affected ACS clinical practice patterns. The use of invasive therapies significantly decreased during the pandemic period, whereas pharmacotherapy was more often prescribed by the cardiologists.

COVID-19 pandemic
acute coronary syndrome
ST-segment elevation myocardial infarction
non-ST-segment elevation myocardial infarction
unstable angina
shclczdzk06204/Shanghai Municipal Key Clinical Specialty
Fig. 1.
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