19 May 2022
We CARE about hearts - EuroPCR 2022
The aims of We CARE are to rebuild patient confidence and help stakeholders provide effective and timely cardiac care through knowledge, education and training.
The COVID-19 pandemic caused huge disruption to healthcare services, with the utilisation of services falling by an estimated one-third compared with pre-pandemic levels.1 Moreover, it is thought that fear of COVID-19 prevented around 40% of patients with MI from seeking medical advice.2 In response, the We CARE initiative was created from a collaboration of PCR and Stent – Save a Life! (SSL) as a global campaign to empower stakeholders, such as healthcare practitioners, national public authorities and the media, to help assure patients that receiving timely cardiovascular treatment is both necessary and safe.
Christoph Naber, a Core Team member of We CARE, explains, “The effects of the COVID-19 pandemic were rapid and dramatic. Discussions with fellow interventional cardiologists revealed that hospital admissions for ACS fell by up to 50% in many countries, while up to 70% of hospital treatments for elective cases were delayed compared with the pre-pandemic era.” Confounding the issue was that healthcare systems were generally unprepared for the pandemic and that patients were receiving unclear advice about what to do and, in some cases, were urged to avoid hospitals.
It became evident that patients with heart disease were delaying or not seeking the treatment they needed, meaning that their heart condition potentially worsened, leading to increased morbidity, such as severe mechanical complications and mortality. For patients with severe symptomatic aortic stenosis, deferral of TAVI because of COVID-19 led to 35% of patients at a single centre experiencing a cardiac event – either urgent TAVI or death – within 3 months.3
“An analysis was performed to evaluate the socio-economic effects of delaying or stopping STEMI treatment during the first lockdown in the UK. For each patient, approximately 2 life years were lost, and an additional cost to the public system of more than €10,000 was incurred if STEMI treatment was delayed” says Christoph Naber.
He stresses that the overall effect of these findings for a country like the UK is significant, with the loss of more than 4000 life years and an estimated cost burden of more than €26 million. Studies are also ongoing in Sweden, Spain, France and the US.
Having launched a global awareness campaign at EuroPCR 2021, We CARE, in its phase II, is currently working on the development of specific country programmes to raise local awareness and meet some needs highlighted by the pandemic. This is where interventional cardiologists are joining forces with other healthcare practitioners and patient organisations locally to advocate and communicate the importance of timely cardiac care to the patients and general public (education), and the public authorities (lobbying).
In addition, all stakeholders need to be prepared for future challenging situations so that history does not repeat itself. To this end, We CARE has brought together international experts in interventional cardiology, epidemiology and infectious diseases to reflect on how to prevent delays in cardiac treatment during future new waves.
Interventional cardiologists and other medical colleagues worldwide are urged to play an active part in the We CARE global and local awareness campaign. Why not join up with other stakeholders to help reverse the trend of treatment avoidance among patients with heart disease?
Want to know more? Visit the website www.wecareabouthearts.org
Clinical and economic burden of reduced PCI access during UK COVID-19 lockdown – A We CARE analysis
References
- Moynihan R, et al. BMJ Open. 2021;11: e045343.
- Mafham MM, et al. Lancet. 2020;396:381–389.
- Ro R, et al. JAMA Netw Open. 2020;3:e2019801.
