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?:abstract
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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], p = 0 003) This was explained by fewer admissions for non-ST-segment elevation ACS (NSTE-ACS;p = 0•002) but not ST-segment elevation myocardial infarction (STEMI;p = 0•31) Patient characteristics and in-hospital mortality were similar For STEMI, door-to-balloon times were similar (70 vs 72 min, p = 0•52) For NSTE-ACS, there was an increase in percutaneous revascularisation (59% vs 49%, p<0•001) and reduction in surgical revascularisation (9% vs 15%, p = 0•005) There were fewer ambulance attendances for cardiac arrests (98 vs 110 per-week, p = 0•04) but no difference for suspected ACS (408 vs 420 per-week, p = 0•44) Community troponin testing was lower throughout the lockdown (182 vs 394 per-week, p<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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