2a) Our guest faculty today are expert #cardiologists & trialists #Stefan_James from @UU_University πΈπͺ and @SanjitSJolly from @McMasterU π¨π¦. #FOAMed @MedTweetorials #Cardiotwitter #MedTwitter pic.twitter.com/0P9Ga56MQz
β cardio-met (@cardiomet_CE) August 18, 2022
3) Their work, entitled “International Perspectives on the Impact of the #COVID-19 Pandemic on #Adherence to #DAPT: A Window into #Acute #Cardiovascular Care,” was supported by an educational grant from AstraZeneca. Disclosures & accreditation statement at https://t.co/gvXca4G9Xm
β cardio-met (@cardiomet_CE) August 18, 2022
5) Increasingly, researchers are starting to take stock of the impact of #COVID19 on #cardiovascular disease and #outcomes. See πhttps://t.co/qgaSd7p4uH and πhttps://t.co/G6kDbalgBW. pic.twitter.com/iHeXckUmWD
β cardio-met (@cardiomet_CE) August 18, 2022
7) Pts with known #CAD are often prescribed #P2Y12i, esp after a #PCI. Consistent #adherence relies on #patient_education & #collaboration with the #healthcare team. As the pandemic disrupted this relationship, the likelihood of nonadherence might be assumed to β¬οΈ. pic.twitter.com/ZXFaQaXhmO
β cardio-met (@cardiomet_CE) August 18, 2022
9a) #StefanJames on the pandemic in πΈπͺ: Swedenβs first case of COVID-19 was reported February 4,2020, and by March 1, only 14 patients had acquired the disease.
β cardio-met (@cardiomet_CE) August 18, 2022
Ten days later, on March 10, community transmission was declared. Still, viewed from abroad, Sweden had …
9c) Sweden broke with most of the rest of the world and never mandated that people wear masks during the pandemic. This approach received both international praise and criticism. pic.twitter.com/I6mUPpvFJT
β cardio-met (@cardiomet_CE) August 18, 2022
10b) … from open surgery to less invasive alternatives requiring less intensive care resources. Regarding hospital presentations with #AMI, data from the nationwide Swedish Coronary Angiography & Angioplasty Registry (#SCAAR), the proportion of STEMI versus NSTEMI …
β cardio-met (@cardiomet_CE) August 18, 2022
11) For Stockholm County–the most severely affected–the incidence rate reduction for total MI interventions was 25% & and was more pronounced for STEMI than NSTEMI. No difference was observed in rates of all cause-mortality during the #pandemic vs the reference period. pic.twitter.com/7SMuduCXgi
β cardio-met (@cardiomet_CE) August 18, 2022
13a) There is no evidence in the registries or in any other stats that there were β¬οΈrates of stent thrombosis, or of lower adherence to any specific pharmacological therapy including DAPT or anticoagulation. The ongoing granular nationwide surveillance of healthcare in Sweden …
β cardio-met (@cardiomet_CE) August 18, 2022
14) Which of the following factors correlated positively with both COVID incidence and COVID mortality in Europe in 2020 and 2021?
β cardio-met (@cardiomet_CE) August 18, 2022
a. population density
b. country of residence GDP per capita
c. age
d. a & b
16) Did you answer correctly? Please return TOMORROW for more education on the impact of the #COVID pandemic on #cardiovascular care and research, this time focusing on π¨π¦!@MedTweetorials #FOAMed #Cardiotwitter #medtwitter
β cardio-met (@cardiomet_CE) August 18, 2022
17b) Today we learn the perspective from Canada from our friend and colleague Dr Sanjit Jolly @sanjitsjolly from @McMasterU π¨π¦. Dr Jolly is an #interventional #cardiologist and experienced #trialist.
— cardio-met (@cardiomet_CE) August 19, 2022
19) An important step was rolling out telephone billing
— cardio-met (@cardiomet_CE) August 19, 2022
codes for physicians to allow care to continue via telephone in many provinces, as the approved telehealth computer vendor systems were overwhelmed. This was good for medication renewals and discussions of compliance.
21) These strategies helped reduce the impact of COVID-19 on chronic #cardiovascular care, although telehealth was viewed as suboptimal due to a lack of clinical exam, #ECG, and #bloodpressure assessments.
— cardio-met (@cardiomet_CE) August 19, 2022
23) The proportion of pts who met recommended first medical contact-to-device times also β¬οΈ significantly (πhttps://t.co/iUbVIlY4vX), being often afraid to come to hospital & presenting later or not at all. pic.twitter.com/1buj0rsie0
— cardio-met (@cardiomet_CE) August 19, 2022
25) There were anecdotal cases of #stent_thrombosis due to a reluctance of patients to contact their physician or go to a pharmacy, but country-level data are not available. pic.twitter.com/jz71hOjszf
— cardio-met (@cardiomet_CE) August 19, 2022
26b) These scenarios may have contributed to poorer overall #cardiovascular outcomes in these patients. On the other hand, telephone visits made physicians more accessible & may have improved follow-up rates after MI.
— cardio-met (@cardiomet_CE) August 19, 2022
27a) #Cardiovascular clinical #research ground to a halt early in the #pandemic with hospitals stopping recruitment and not allowing research nurses or staff on site. Many were redeployed to COVID-19 clinical care or research.
— cardio-met (@cardiomet_CE) August 19, 2022
27c) Patients were afraid of coming to hospital for follow-up research visits. Laboratory visits were often delayed & local laboratories were used instead of, for example, an overwhelmed central hospital site that had become a COVID-19 center. pic.twitter.com/vEuokRSKvJ
— cardio-met (@cardiomet_CE) August 19, 2022
28a) Given their research expertise, a number of #cardiology researchers pivoted to #COVID-19 trials during the pandemic, to test repurposed medications. These trials were extremely difficult as regulatory agencies often expected the same processes as in prepandemic times . . . pic.twitter.com/SIylkWyLHQ
— cardio-met (@cardiomet_CE) August 19, 2022
28c) … would have dramatically improved the speed and efficiency of trials during the #pandemic, and could have saved lives.
— cardio-met (@cardiomet_CE) August 19, 2022
30) See πhttps://t.co/pRQil90G1s . FDA provided general considerations to assist sponsors in assuring the safety of trial participants, maintaining compliance with #GCP, & minimizing risks to trial integrity for the duration of the COVID-19 public health emergency.
— cardio-met (@cardiomet_CE) August 19, 2022
31) So now, #physicians #PAs #nurses #NPs #pharmacists can go to https://t.co/t1S9I0CFsn and collect 0.5h CE/#CME. And follow us here to be sure you don't miss the next installment of our "#COVID vs #DAPT" international perspectives series! Thanks to @SanjitSJolly & #StefanJames
— cardio-met (@cardiomet_CE) August 19, 2022