EuroPCR: We CARE Initiative – UK Health Economic Analysis of Long-Term Health Outcomes and Cost for STEMIs During COVID-19 UK Lockdown Presented

We CARE 2022: Understanding the economic and societal burden of the pandemic

Paris, France, May 19, 2022 — We CARE, a joint initiative of PCR and Stent – Save a Life!, dedicated to restoring faith in cardiovascular healthcare and increasing awareness of the importance of timely and accessible treatment, is presenting a first study at EuroPCR 2022: a UK health economic analysis of the long-term health outcomes and cost for STEMIs during the COVID-19 UK lockdown.

When We CARE – a joint initiative of PCR and Stent – Save a Life! – was launched during EuroPCR 2021, the situation was dire, with the COVID pandemic leaving patients “consistently deprived of timely cardiovascular treatment.”

The implications were manifest for individual patients and society, where an “unwillingness to seek medical help, even in emergency circumstances such as for myocardial infarction or decompensated heart failure”, could only translate into long-term health complications.

The mission of We CARE is to restore faith in cardiovascular healthcare, increase awareness of the importance of timely treatment, and underline key issues of access and time.

Individual cardiovascular health and the economic costs of a pandemic – a We CARE analysis

A recent May report from the World Health Organization reported almost 15 million excess deaths worldwide during the COVID-19 pandemic. 2
Mortality from inadequate cardiovascular care and lack of access to primary PCI certainly played a part in these numbers, with a reduction seen throughout the world in hospital admissions for acute cardiac conditions such as STEMI or patients with high-risk aortic stenosis.

• For those who survived, what are the short-and long-term implications for their overall quality of life?

• What is the economic impact of these long-term effects for our society and our healthcare systems?

An evidence-based response

We CARE has undertaken several national studies which are currently underway in Spain, Sweden, the UK and the United States. The first – to be presented during EuroPCR 2022 –is from the United Kingdom and looks at the long-term health outcomes and cost for STEMIs occurring in England during the UK COVID-19 lockdown in March-April 2020, comparing it with an equivalent STEMI population before lockdown.¹

From the UK study: lack of care leads to a greater societal burden

Dr Mattia Lunardi, a study author, noted that:

• “...patients were frightened to go to hospitals or clinics – even for urgent or acute situations, from heart attacks to strokes, and even cancer.”

• The call by the government to "stay at home" only further underlined that reticence to seek proper care.

• The results were catastrophic, with the UK study showing that “people died at home. And if they didn’t die, they survived with poor heart function, increasing the number of future heart failure patients and related care.” Patients have a “lower survival, worse prognosis, and are in greater need for treatment of late complications from heart attacks.”

• Fewer hospital admissions meant fewer interventions for heart attacks, leading to higher mortality, higher heart failure and other heart attack complications, which in turn leads to higher future treatment costs.

• Work absenteeism due to heart disease complications also adds to higher societal costs.

From the UK study: a financial burden

For society, healthcare costs are rising as a consequence of these medical complications caused by the lockdown:

• “an average loss of 1.86 years of survival for a patient having a STEMI during the first month of lockdown, compared with pre-lockdown” with “a corresponding loss of Quality of Life”.
• Beyond the actual healthcare resources used, there is a subsequent cost to society that is “higher by more than £10,000 per patient over a lifetime.”

From the UK study: patient awareness

• “Reluctance to seek hospital care with STEMI has a substantial effect on patients’ outcomes and cost” with the “implication” that overall COVID-19 patient outcomes and cost are “not limited to the initial lockdown period and may be used to estimate the effect of subsequent waves of the virus.”
• Underlining the importance of the patient and the general public knowing that “if you have any symptom or doubts, go to the hospital. If you wait, you die, or you die sooner than you would have in normal times, with a worsening quality of life resulting from complications due to lack of treatment.”

Cardiovascular care – local and national strategies

We CARE is committed to preventing or mitigating the “collateral impact” of the COVID-19 pandemic and any future potential crisis.
In the second phase of its work, We CARE shifts focus locally and nationally to develop a global network and an advocacy platform based through local programmes, creating evidenced-based proposals to empower all players in healthcare systems and rebuild cardiac patients’ trust. A French programme is now under development to help target the patients, the general public and public authorities.

Cardiovascular care – in a post-pandemic world

Turning towards a post-pandemic future, Phase 3 of the We CARE initiative will build on these local and international foundations and continue to bring together cardiovascular intervention specialists with other stakeholders in healthcare on a local, national and international level. We CARE, by conjugating the expertise of PCR and Stent – Save a Life!, is developing the tools necessary for prevention and preparedness for any future challenges to the cardiovascular community and those it serves. The tide is turning, but the work of We CARE continues so that no patient suffers from a lack of faith in – or lack of access to – adequate and appropriate cardiovascular care.

References

1. A model to predict potential clinical and economic burden associated with reductions in PCI treatment access during the Covid-19 lockdown in England.
   Mattia Lunardi, Simon Eggington, Jan Pietzsch, Natalie Papo, Silke Walleser-Autiero, Andreas Baumbach, Francesco Maisano, Flavio Ribichini, Darren Mylotte, Emanuele Barbato, Jan J. Piek, Mamas Mamas, Christoph K. Naber, William Wijns

   Press conference: 8:00-8:45 Tuesday 17 May

   Presentation, Thursday 19 May 2022 at EuroPCR 2022
   ROOM 242B in session “Primary PCI: new issues, new solutions” 08:30 - 10:00

2. https://www.who.int/data/stories/global-excess-deaths-associated-with-covid-19- january-2020-december-2021

About EuroPCR 2022

The World-Leading Course in interventional cardiovascular medicine and the official annual meeting of the European Association of Percutaneous Cardiovascular Interventions (EAPCI) will take place from 17 to 20 May 2022, in Paris and online. The detailed Course Programme is available on: www.pcronline.com/Courses/EuroPCR/Programme/2022/Course-Programme

About PCR

The mission of PCR is to serve the needs of each individual patient by helping the cardiovascular community to share knowledge, experience and practice. PCR offers a large range of many other educational meetings and resources for the continuing education of the interventional cardiovascular community. These include major annual Courses across the globe, e-Learning with high-profile PCR Webinars, Courses specifically dedicated to valvular heart disease, tailor-made PCR Seminars on specific topics, online resources and medical publications such as EuroIntervention, the official journal of the EAPCI. Gateways to all PCR activities are available on www.pcronline.com

For further information, please contact Sally Collingridge, PCR Marketing Communication Manager: scollingridge@europa-group.com

About the EAPCI

The European Association of Percutaneous Cardiovascular Interventions (EAPCI) is a branch of the European Society of Cardiology. Its mission is to reduce the burden of cardiovascular disease through percutaneous cardiovascular interventions. This dynamic association represents a community of over 7,000 healthcare professionals by helping them remain up to date in the constantly evolving field of PCI by publishing research and providing training and certification programmes. The EAPCI also advocates for the best possible access to life saving treatments for patients through data-based advocacy at a European level.

About We CARE

The We CARE initiative was inspired by the challenging global pandemic of COVID-19. It aims to empower all stakeholders – healthcare practitioners, national authorities, and the media – to help patients rapidly regain trust that receiving timely cardiovascular treatment is both necessary and safe.

For further information, please contact Sandrine Wallace: sandrine.wallace.wecare@gmail.com.

More details concerning We CARE will be found on this page: www.wecareabouthearts.org Activities can be followed on social medial using the hashtag: #WeCareAboutHearts https://twitter.com/WeCareAboutHea1 https://www.linkedin.com/company/wecareabouthearts

The European Association of Percutaneous Cardiovascular Interventions (EAPCI) is a branch of the European Society of Cardiology. Its mission is to reduce the burden of cardiovascular disease through percutaneous cardiovascular interventions. This dynamic association represents a community of over 7,000 healthcare professionals by helping them remain up to date in the constantly evolving field of PCI by publishing research and providing training and certification programmes. The EAPCI also advocates for the best possible access to life saving treatments for patients through data-based advocacy at a European level.

About Stent – Save a Life!

The Stent – Save a Life! global initiative aims to improve access to guideline-complying therapy and the lifesaving indication of primary percutaneous coronary intervention (p-PCI), thereby reducing mortality and morbidity in patients suffering from acute myocardial infarction (AMI). More details of Stent – Save a Life! activities will be found here: www.stentsavealife.com

For further information, please contact Sandrine Wallace: contact@stentsavealife.com.