Therapeutic Advances in Cardiovascular Disease最新文献

{"title":"The subclinical hypothyroid state might predict 30-day readmission in patients admitted with acute heart failure syndrome and reduced left ventricular ejection fraction.","authors":"Muhammad Saad,&nbsp;Andrisael Garcia Lacoste,&nbsp;Pooja Balar,&nbsp;Aiyi Zhang,&nbsp;Timothy J Vittorio","doi":"10.1177/1753944720977742","DOIUrl":"https://doi.org/10.1177/1753944720977742","url":null,"abstract":"<p><strong>Introduction: </strong>Thyroid hormone (TH) has an essential role on the functional capability of cardiac muscle with its gene modulation and induction of vasodilatory effects. There is considerable evidence to suggest the role of TH in patients with acute coronary syndrome, but less is known about its prognostic role in heart failure (HF) patients. We aim to evaluate the association between subclinical hypothyroid state (SCHS) and event rates including 30-day all-cause and HF readmission in patients with an index hospitalization for acute HF syndrome (AHFS).</p><p><strong>Methodology: </strong>A retrospective chart review analysis of 2335 patients admitted with the diagnosis of AHFS between 1 January 2007 and 31 December 2017 was conducted. SCHS was defined as thyroid-stimulating hormone (TSH) level >4.50 mIU/L with a normal thyroxine (T₄) level. Patients with pre-existing thyroid disease or receiving thyroid replacement therapy were excluded. HF with preserved ejection fraction (HFpEF) was defined as left ventricular ejection fraction (LVEF) >40% and HF with reduced ejection fraction (HFrEF) was defined as having LVEF ⩽40%. Percentage of 30-day, 3-month and 6-month all-cause readmission and mortality rates were calculated in both cohorts of AHFS (HFpEF and HFrEF) with and without SCHS.</p><p><strong>Results: </strong>The mean age of the 2335 AHFS population was 65 (±14.8) years. Of the 2335 patients admitted with AHFS, 1228 (52.6%) patients were found to have HFrEF and 1107 (47.4%) with HFpEF. There were 170 (7.3%) patients with AHFS found to have SCHS. There were more males than females (54% <i>versus</i> 46%). The percentage of hospital readmission within 30 days was higher for patients with SCHS compared with those without SCHS in the HFrEF group (42% <i>versus</i> 30%, <i>p</i> = 0.001). Hospital readmission within 30 days for patients with SCHS compared with those without SCHS in the HFpEF group did not differ (36.5% <i>versus</i> 31%, <i>p</i> = 0.47). Additionally, all-cause mortality was higher among patients with SCHS compared with patients without SCHS in the HFrEF group (18.7% <i>versus</i> 7.0%, <i>p</i> < 0.001). All-cause mortality was found similar in both arms of the HFpEF group (9.5% <i>versus</i> 7.7%, <i>p</i> = 0.73).</p><p><strong>Conclusion: </strong>During an index hospital admission for AHFS, SCHS was an independent predictor of readmission in 30 days in patients with HFrEF but not in patients with HFpEF. Additionally, it was related to adverse outcome such as all-cause mortality in HFrEF patients but not in HFpEF patients. Further studies regarding the concept of tissue thyroid and the potential for a therapeutic target are warranted.</p>","PeriodicalId":23035,"journal":{"name":"Therapeutic Advances in Cardiovascular Disease","volume":"14 ","pages":"1753944720977742"},"PeriodicalIF":2.3,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753944720977742","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38725467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inter- and intra-core laboratory variability in the quantitative coronary angiography analysis for drug-eluting stent treatment and follow up.","authors":"Shigenori Ito, Kanako Kinoshita, Akiko Endo, Ryoko Kami, Yuko Kotake, Masato Nakamura","doi":"10.1177/1753944720958982","DOIUrl":"10.1177/1753944720958982","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate inter-core laboratory variability of quantitative coronary angiography (QCA) parameters in comparison with intra-core laboratory variability in a randomized controlled trial evaluating drug-eluting stents.</p><p><strong>Methods: </strong>A total of 50 patients with 62 coronary lesions were analyzed by four analysis experts belonging to an Angiographic Core Laboratory (ACL: 1 expert) and a Cardiovascular Imaging Core Laboratory (CICL: 3 experts). QCA was based on the same standard operating procedure, but selections of projection and cine frames were at the discretion of each analyst. Inter- and intra-core laboratory variabilities were evaluated by accuracy, precision, Bland Altman analysis, and coefficient of variation.</p><p><strong>Results: </strong>Pre-MLD (minimal lumen diameter) was significantly smaller in results from ACL than those from all CICL experts. Number of analyzed projections did not affect pre-MLD results. Acute gain was larger in ACL than in CICL2. No significant difference was observed in late loss and loss index between inter-core laboratories. Agreement between core labs in the Bland-Altman analysis for each QCA parameter was as follows (mean difference, 95% limits of agreement): pre-MLD (-0.32, -0.74 to 0.10), stent MLD (0.08, -0.28 to 0.44), acute gain (0.22, -0.44 to 0.88), and late loss (-0.07, -0.69 to 0.55). Agreement between analysts in CICL (mean difference, 95% limits of agreement) was: pre MLD (-0.03, -0.37 to 0.31), stent MLD (0.15, -0.15 to 0.45), acute gain (0.05, -0.45 to 0.55), and late loss (0.04, -0.52 to 0.60). The widest limits of agreement among three analyses were shown in both analyses. Width of limited agreement in the intra-core laboratory analysis tended to be smaller than the inter-core laboratory analysis with these parameters. Coefficient of variation tended to be larger in lesion length (LL), acute gain, late loss, and loss index in inter- and in intra- core laboratory comparisons.</p><p><strong>Conclusion: </strong>Inter-core laboratory QCA variability in late loss and loss index analysis could be similar to intra-core laboratory variability, but more strict alignment between core laboratories would be necessary for initial procedural data analysis.</p>","PeriodicalId":23035,"journal":{"name":"Therapeutic Advances in Cardiovascular Disease","volume":"14 ","pages":"1753944720958982"},"PeriodicalIF":2.6,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1a/a2/10.1177_1753944720958982.PMC7534069.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38434500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular approach for acute limb ischemia without thrombolytic therapy.","authors":"Keisuke Fukuda,&nbsp;Yoshiaki Yokoi","doi":"10.1177/1753944720924575","DOIUrl":"https://doi.org/10.1177/1753944720924575","url":null,"abstract":"<p><strong>Background: </strong>Endovascular therapy for acute lower limb ischemia (ALLI) has developed and demonstrated safety and efficacy. The purpose of this study was to assess clinical outcomes in patients treated for ALLI with conventional endovascular or surgical revascularization.</p><p><strong>Method: </strong>This study was a retrospective single-center review. Consecutive patients with ALLI treated with conventional endovascular revascularization (ER) without thrombolytic agent or surgical revascularization (SR) between 2008 and 2014 were investigated. The 1 year and 3 year amputation rate and mortality rate were assessed by time-to-event methods, including Kaplan-Meier estimation.</p><p><strong>Result: </strong>A total of 64 limbs in 62 patients with ALLI due to thromboembolism or thrombosis of a native artery, bypass graft, or previous stented vessel were included. The majority of limbs (90.9%) presented with Rutherford clinical categories 1 to 2 ischemia. Technical success rate was 95.5% in ER and 92.9% in SR group (<i>p</i> = 0.547). Overall amputation rates were 9.1% in ER <i>versus</i> 9.5% in SR after 1 year (<i>p</i> = 0.971) and 9.1% in ER <i>versus</i> 11.9% in SR after 3 year (<i>p</i> = 0.742). Overall mortality rates were 15% in ER <i>versus</i> 7.1% in SR after 1 year (<i>p</i> = 0.491) and 15% in ER <i>versus</i> 11.2% in SR after 3 year (<i>p</i> = 0.878).</p><p><strong>Conclusion: </strong>Endovascular or surgical revascularization of ALLI resulted in comparable outcomes in limb salvage and mortality rate at 1 year and 3 year. Conventional endovascular therapy without thrombolytic agent such as stenting, balloon angioplasty, or catheter-directed thrombosuction may be considered as a treatment option for ALLI.</p>","PeriodicalId":23035,"journal":{"name":"Therapeutic Advances in Cardiovascular Disease","volume":"14 ","pages":"1753944720924575"},"PeriodicalIF":2.3,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753944720924575","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37961138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exercise therapy in routine management of peripheral arterial disease and intermittent claudication: a scoping review.","authors":"Ukachukwu O Abaraogu, Onyinyechukwu D Abaraogu, Philippa M Dall, Garry Tew, Wesley Stuart, Julie Brittenden, Chris A Seenan","doi":"10.1177/1753944720924270","DOIUrl":"10.1177/1753944720924270","url":null,"abstract":"<p><strong>Background: </strong>Little is known about the extent to which routine care management of peripheral arterial disease (PAD) and intermittent claudication (IC) align with best practice recommendations on exercise therapy. We conducted a scoping review to examine the published literature on the availability and workings of exercise therapy in the routine management of patients with PAD and IC, and the attitude and practice of health professionals and patients.</p><p><strong>Methods: </strong>A systematic search was conducted in February 2018. The Cumulative Index of Nursing and Allied Health Literature, Ovid MEDLINE, Allied and Complementary Medicine Database, ScienceDirect, Web of Science and the Directory of Open Access Repositories were searched. Hand searching of reference lists of identified studies was also performed. Inclusion criteria were based on study aim, and included studies that reported on the perceptions, practices, and workings of routine exercise programs for patients with IC, their availability, access, and perceived barriers.</p><p><strong>Results: </strong>Eight studies met the eligibility criteria and were included in the review. Studies conducted within Europe were included. Findings indicated that vascular surgeons in parts of Europe generally recognize supervised exercise therapy as a best practice treatment for IC, but do not often refer their patients for supervised exercise therapy due to the unavailability of, or lack of access to supervised exercise therapy programs. Available supervised exercise therapy programs do not implement best practice recommendations, and in the majority, patients only undergo one session per week. Some challenges were cited as the cause of the suboptimal program implementation. These included issues related to patients' engagement and adherence as well as resource constraints.</p><p><strong>Conclusion: </strong>There is a dearth of published research on exercise therapy in the routine management of PAD and IC. Available data from a few countries within Europe indicated that supervised exercise is underutilized despite health professionals recognizing the benefits. Research is needed to understand how to improve the availability, access, uptake, and adherence to the best exercise recommendations in the routine management of people with PAD and IC.</p>","PeriodicalId":23035,"journal":{"name":"Therapeutic Advances in Cardiovascular Disease","volume":"14 ","pages":"1753944720924270"},"PeriodicalIF":2.6,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/22/99/10.1177_1753944720924270.PMC7273548.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37981177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antithrombotic and hemostatic stewardship: evaluation of clinical outcomes and adverse events of recombinant factor VIIa (Novoseven^®) utilization at a large academic medical center.","authors":"Kassandra Marsh, David Green, Veronica Raco, John Papadopoulos, Tania Ahuja","doi":"10.1177/1753944720924255","DOIUrl":"10.1177/1753944720924255","url":null,"abstract":"<p><strong>Background: </strong>Recombinant factor VIIa (rFVIIa) (Novoseven®) is utilized for the reversal of anticoagulation-associated bleeding and refractory bleeding in cardiac surgery. In August 2015, rFVIIa was transferred from the blood bank to the pharmacy at New York University (NYU) Langone Health. Concordantly, an off-label dosing guideline was developed. The objective of this study was to describe utilization and cost of rFVIIa and assess compliance to our dosing guideline.</p><p><strong>Methods: </strong>We performed a retrospective, observational review of rFVIIa administrations post-implementation of an off-label dosing guideline. All patients who received rFVIIa between September 2015 and June 2017 were evaluated. For each rFVIIa administration, anticoagulation and laboratory values, indications for use, dosing, ordering and administration times, concomitant blood products, and adverse events were collected. Adverse events included venous thromboembolism, stroke, myocardial infarction, and death due to systemic embolism and mortality. The primary endpoint was the utilization of rFVIIa in accordance with the off-label dosing guideline. Secondary endpoints included hemostatic efficacy of rFVIIa, adverse events, blood products administered, and cost-effectiveness of rFVIIa transition to pharmacy.</p><p><strong>Results: </strong>A total of 63 patients [pediatric (<i>n</i> = 6), adult (<i>n</i> = 57)] received rFVIIa, with the majority of use for refractory bleeding after cardiac surgery. The utilization of rVIIa decreased after development of the off-label dosing guideline and transition from blood bank to pharmacy. The total incidence of thromboembolic events within 30 days was 19.6%; 17.6% arterial and 2% venous; 70% of patients with an adverse event were over 70 years of age. Use of rFVIIa reduced the median number of units of blood products administered.</p><p><strong>Conclusion: </strong>Administration of rFVIIa for cardiac surgery appears to be effective for hemostasis. Transitioning rFVIIa from the blood bank to pharmacy and implementation of a dosing guideline appears to have reduced utilization. Patients receiving rFVIIa should be monitored for thromboembolic events. Elderly patients may be at higher risk for thromboembolic events.</p>","PeriodicalId":23035,"journal":{"name":"Therapeutic Advances in Cardiovascular Disease","volume":"14 ","pages":"1753944720924255"},"PeriodicalIF":2.6,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f7/1f/10.1177_1753944720924255.PMC7249557.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37972465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ivabradine and endothelium: an update.","authors":"Lucia Dallapellegrina,&nbsp;Edoardo Sciatti,&nbsp;Enrico Vizzardi","doi":"10.1177/1753944720934937","DOIUrl":"https://doi.org/10.1177/1753944720934937","url":null,"abstract":"<p><p>Ivabradine is a pure heart-rate lowering drug that is nowadays used, accordingly to the last ESC Guidelines, to reduce mortality and heart failure (HF) hospitalization in patients with HF with reduced ejection fraction and in symptomatic patiens with inappropriate sinus tachycardia. Moreover, interesting effect of ivabradine on endothelial and myocardial function and on oxidative stress and inflamation pathways are progressively emerging. The aim of this paper is to highlight newer evidences about ivabradine effect (and consequently possible future application of the drug) in pathological settings different from guidelines-based clinical practice.</p>","PeriodicalId":23035,"journal":{"name":"Therapeutic Advances in Cardiovascular Disease","volume":"14 ","pages":"1753944720934937"},"PeriodicalIF":2.3,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753944720934937","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38107331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to <i>DUSP-1</i> gene expression is not regulated by promoter methylation in diabetes-associated cardiac hypertrophy.","authors":"","doi":"10.1177/1753944720956752","DOIUrl":"https://doi.org/10.1177/1753944720956752","url":null,"abstract":"","PeriodicalId":23035,"journal":{"name":"Therapeutic Advances in Cardiovascular Disease","volume":"14 ","pages":"1753944720956752"},"PeriodicalIF":2.3,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753944720956752","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38398882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inter-observer variation of Syntax score among cardiac surgeons, clinical and interventional cardiologists.","authors":"Gustavo Neves de Araujo,&nbsp;Tiago Luiz Luz Leiria,&nbsp;Mariana Vargas Furtado,&nbsp;Bruno da Silva Matte,&nbsp;Guilherme Pinheiro Machado,&nbsp;Ana Maria Krepsky,&nbsp;Luiz Carlos Corsetti Bergoli,&nbsp;Sandro Cadaval Goncalves,&nbsp;Marco Vugman Wainstein,&nbsp;Carisi Anne Polanczyk","doi":"10.1177/1753944720924254","DOIUrl":"https://doi.org/10.1177/1753944720924254","url":null,"abstract":"<p><strong>Background: </strong>Despite the complexity of SYNTAX score (SS), guidelines recommend this tool to help choosing between coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) in patients with left main of three-vessel coronary artery disease. The aim of this study was to compare the inter-observer variation in SS performed by clinical cardiologists (CC), interventional cardiologists (IC), and cardiac surgeons (CS).</p><p><strong>Methods: </strong>Seven coronary angiographies from patients with left main and/or three-vessel disease chosen by a heart team were analyzed by 10 CC, 10 IC and 10 CS. SS was calculated <i>via</i> SYNTAX website.</p><p><strong>Results: </strong>Kappa concordance was very low between CC and CS (k = 0.176), moderate between CS and IC (k = 0.563), and moderate between CC and IC (0.553). There was a statistically significant difference between CC, who classified more cases as low complexity (70%), and CS, who classified more cases as moderate complexity (80%) (<i>p</i> = 0.041).</p><p><strong>Conclusion: </strong>Concordance between SS analyzed by CC, CS and IC is low. The usefulness of SS in decision-making of revascularization strategy is undeniable and evidence supports its use. However, this study highlights the importance of well-trained professionals on calculating the SS. It could avoid misclassification of borderline cases.</p>","PeriodicalId":23035,"journal":{"name":"Therapeutic Advances in Cardiovascular Disease","volume":"14 ","pages":"1753944720924254"},"PeriodicalIF":2.3,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753944720924254","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37963232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current status of white coat hypertension: where are we?","authors":"Gani Nuredini, Alec Saunders, Chakravarthi Rajkumar, Michael Okorie","doi":"10.1177/1753944720931637","DOIUrl":"10.1177/1753944720931637","url":null,"abstract":"<p><p>White coat hypertension (WCH) is characterised by an elevated clinic blood pressure (BP) with normal ambulatory or home BP. It is well recognised in clinical practice and occurs in approximately one-third of untreated patients with elevated clinic BP. Current evidence suggests that WCH is associated with cardiovascular risk factors, including the development of sustained hypertension and the presence of target organ damage. However, its effects on cardiovascular outcomes remain a matter of debate. There is also insufficient evidence from randomised controlled trials to determine whether WCH warrants treatment. This narrative review aims to provide an update on the current understanding of WCH. It focuses on the clinical characteristics and potential implications of WCH, its relationship to cardiovascular risk and the evidence regarding treatment. Gaps in existing research are also highlighted.</p>","PeriodicalId":23035,"journal":{"name":"Therapeutic Advances in Cardiovascular Disease","volume":"14 ","pages":"1753944720931637"},"PeriodicalIF":2.6,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/58/43/10.1177_1753944720931637.PMC7318827.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38086205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The missing acute coronary syndromes in the COVID-19 era.","authors":"Neil Ruparelia,&nbsp;Vasileios Panoulas","doi":"10.1177/1753944720977732","DOIUrl":"https://doi.org/10.1177/1753944720977732","url":null,"abstract":"<p><strong>Aims: </strong>To determine whether the number of patients presenting with acute coronary syndromes has reduced during the COVID-19 pandemic.</p><p><strong>Methods: </strong>Numbers of primary percutaneous coronary intervention (PPCI) activations, ST elevation myocardial infarctions (STEMIs) and non-ST elevation myocardial infarctions (NSTEMIs) in a large tertiary Greater London centre and a large district general hospital, both of which have on-site heart attack centres, were collected. We compared the number of PPCI activations, STEMI, NSTEMIs and all MIs prior to the COVID-19 era (January to third week of February 2020), after the start of some COVID-19 restrictions taking place (fourth week of February 2020) and after formal instruction by the United Kingdom Government that all citizens were to observe strict social distancing measures (20 March 2020). We further obtained data for the corresponding weekly figures from 2019.</p><p><strong>Results: </strong>The average weekly figure of all myocardial infarction in 2020, prior to the COVID-19 social distancing restrictions/awareness in the UK (beginning of January to third week of February), did not differ when compared with corresponding weeks in 2019 (23.3 ± 5.4 in 2019 <i>versus</i> 21.13 ± 3.5, <i>p</i> = 0.411).With increased media reporting and associated public awareness of the threat of COVID-19 (last week of February), there was a significant reduction in all myocardial infarction (27.1 ± 4.7 in 2019 <i>versus</i> 15.9 ± 3.6 in 2020, <i>p</i> < 0.001). Following official governmental instruction that mandated strict social distancing and the 'stay at home' campaign, the weekly figures of STEMI (15 ± 3.5 in 2019 <i>versus</i> 10 ± 4.4 in 2020, <i>p</i> = 0.013), NSTEMI (13 ± 2.6 in 2019 <i>versus</i> 4.7 ± 2.3 in 2020, <i>p</i> = 0.038) and all myocardial infarction (28 ± 6.1 in 2019 <i>versus</i> 14.7 ± 5.7 in 2020, <i>p</i> = 0.008) have remained significantly reduced.</p><p><strong>Conclusion: </strong>We have observed an unexpected major decline in presentations (and treatment) of the entire spectrum of acute coronary syndromes following the beginning of the COVID-19 pandemic and nationwide public-health measures that have promoted the importance of strict social distancing and self-quarantine.</p>","PeriodicalId":23035,"journal":{"name":"Therapeutic Advances in Cardiovascular Disease","volume":"14 ","pages":"1753944720977732"},"PeriodicalIF":2.3,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753944720977732","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38334346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}