Heart attack deaths have soared by a fifth during the pandemic, according to a major review that warns of huge ‘global collateral damage’ from Covid and lockdowns.
An analysis of nearly 200 studies by researchers at the University of Leeds found that the number of deaths among people hospitalized with serious heart problems jumped 17% in two years.
Patients also waited more than an hour longer than usual for heart calls and heart attacks between December 2019 and December 2021. And the number of heart operations performed worldwide fell by 34%.
Previous research in the UK showed that many people were too afraid to go to hospital in case they caught the virus or were a burden on health services during the early stages of the pandemic.
Tens of millions of GP appointments and operations have been canceled or postponed, which may have led to people getting worse, and staff have been redeployed to care for people infected with the virus.
Dr Ramesh Nadarajah, a cardiologist who led the review, said: “Heart disease is the number one cause of death in most countries – and analysis shows that during the pandemic, people around the world are not did not receive the cardiac care they should have received.
“It will have ramifications. The longer people wait for treatment for a heart attack, the greater the damage to their heart muscle, leading to complications that can be fatal or lead to chronic poor health.
The researchers also found that heart attack cases fell by 34% and heart attack hospitalizations fell by a third. They said this was due to more undetected cases, rather than fewer heart problems.
Separate data from the British Heart Foundation (BHF) shows there were more than 300,000 people waiting for heart treatment in England at the end of March – a figure that has been rising for almost two years.
Heart disease is one of the leading causes of death in the UK and is responsible for a quarter of deaths each year – over 160,000. There are around 7.6 million people living with the diseases heart and circulatory systems in Great Britain.
The Leeds researchers identified 158 studies – from 48 countries and covering the two years to December 2021 – that looked at the impact of Covid on cardiovascular services, including hospitalizations, heart disease management appointments, tests and mortality rates.
The results, which the researchers describe as the “first global assessment of how cardiovascular services coped during the pandemic”, show that 22% fewer people were hospitalized with a serious heart attack – when the one of the blood pumping arteries in the body is completely blocked.
And the number of people admitted to hospital with a less severe heart attack – when the artery is only partially blocked – has fallen by a third, according to findings published in the European Heart Journal.
The researchers warned that the drop was “not due to fewer heart attacks, but fewer people being hospitalized for treatment”.
People suffering from heart attack and heart failure “stayed away or could not be admitted to hospital” during this period, as health systems around the world were under “pressure extreme and people were afraid of catching Covid,” the Leeds team said.
The largest increase in heart attack deaths has been mostly seen in low- and middle-income countries.
But in the UK they were still up 7% from pre-pandemic levels.
In addition to the hospitalization figures, patients also had to wait longer to be treated for a heart attack.
Around the world, people suffering from serious heart attacks have been forced to wait 69 minutes longer than pre-pandemic levels to receive medical assistance.
The researchers warned that a person’s chance of surviving a major heart attack “depends on prompt and appropriate treatment”.
Meanwhile, the ‘gold standard’ operation for heart attack patients has fallen by 40% in the poorest countries and 24% in the richest countries.
Coronary angioplasties – used as an emergency treatment after a heart attack – involve inserting a short wire-mesh tube, called a stent, into the artery permanently to allow blood to flow more freely.
The researchers said these patients were often treated with anti-clot drugs, such as alteplase and streptokinase. This was particularly the case in low- and middle-income countries, where the use of these drugs almost doubled.
The number of people awaiting routine hospital treatment in England hit a new record high of 6.36 million. NHS data shows one in nine people were in the queue for elective operations such as hip and knee replacements and cataract surgery in March – up from 6.18million in February
Ambulance figures for April show waits for paramedics fell from March, but were higher than nearly every other month since records began. Ambulances took an average of 51 minutes and 22 seconds to respond to Category 2 calls, such as burns, epilepsy and stroke. That’s nine minutes and 41 seconds faster than a month earlier
And the number of implantable electronic devices to treat abnormal heart rhythms, such as pacemakers, inserted during the pandemic was 49% lower than pre-Covid levels, the researchers found.
The researchers said their findings show a “substantial global decline” in hospitalizations among people with cardiovascular disease, leading to an increase in the number of people dying at home from heart disease.
The blow to cardiovascular services has been seen around the world, but has been “exacerbated in low- to middle-income countries,” the researchers said.
And they believe their findings “underestimate the true magnitude” of Covid’s impact on cardiac services due to the “sparse” data available for poorer countries.
The researchers said: “The collateral cardiovascular damage caused by missed diagnoses and delayed treatments will continue to accumulate unless mitigation strategies are quickly implemented.
“Delaying interventional procedures, especially for structural heart disease, leaves many patients at high risk for adverse effects.”
Professor Chris Gale, consultant cardiologist and lead author of the study, said: “The impact of the Covid pandemic on cardiovascular care and the outcomes will be with us for a long time to come.
“There is no doubt that there will continue to be deaths and illnesses that would not otherwise have occurred. Urgent action is needed to address the burden of cardiovascular disease left as a result of the pandemic.
The BHF says there is an urgent need for a plan to help cardiac services in England cope with the growing number of people who now need treatment, with 309,796 waiting for cardiac services by march.
BHF Associate Medical Director and Consultant Cardiologist Dr Sonya Babu-Narayan said: “We need a comprehensive and specific cardiovascular plan to address the burden of cardiovascular care, including the backlog – and provide immediate and long-term solutions to our cardiovascular problems. labor shortage.
“Without it, we will continue to see heart attacks, lasting heart damage, or even premature deaths that could have been prevented.”
It comes after official figures from NHS England show the backlog of patients has skyrocketed to 6.4 million, with one in nine people waiting for routine treatment.
And ambulances in England took an average of 51 minutes and 22 seconds to respond to heart attack calls in March. This is compared to a response time of 40 minutes set out in NHS guidelines.
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