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Will the COVID-19 pandemic have long-term effects on clinicians?

A survey of cardiologists and cardiovascular team members, conducted in November 2020, suggested that the prevalence of professional burnout nearly doubled during local COVID-19 surges. Just under a quarter of respondents had reported plans to reduce clinical work hours in 2021.

Half of the 1,288 survey respondents reported having provided direct care to COVID-19 patients. One in five said they did so without having adequate personal protective equipment, a group that was particularly prone to burnout.

Results of this and other studies were featured at this year's virtual meeting of the American College of Cardiology. The following are some of the highlights.

WASE-COVID

In a win for artificial intelligence (AI), automatic quantification was an improvement over manual contouring in the assessment of echocardiographic parameters deemed to be independent predictors of mortality in SARS-CoV-2-infected people in WASE-COVID.

Authors of the observational study suggested that AI contouring may also be useful in a wider patient population outside the 870-person cohort of hospitalized COVID-19 patients who had had clinically indicated echocardiograms.

ISCHEMIA

Completeness of revascularization for stable ischemic heart disease may be an important factor in whether an invasive therapeutic approach -- coronary artery bypass grafting or percutaneous coronary intervention -- is better than medical therapy alone, the ISCHEMIA group suggested.

Invasive management achieving anatomic and functional completeness was associated with improvements in certain quality-of-life and clinical outcomes compared with conservative management, according to two post-hoc analyses of ISCHEMIA.

Ability to achieve completeness of revascularization is not always predictable, however, and whether always striving for completeness would safely improve outcomes is unknown, investigators warned.

REALITY

For MI patients with anemia, a restrictive blood transfusion strategy failed to meet non-inferiority compared with liberal transfusion when it came to major adverse cardiovascular event rates at 1 year, according to the randomized REALITY trial from France and Spain.

The restrictive strategy had been hampered by events occurring between 30 days and 1 year.

SAFE-PAD

A large observational study of Medicare patients did not support a link between paclitaxel-coated devices for femoropopliteal artery revascularization and mortality.

Sensitivity analyses -- namely instrumental variable analysis, falsification endpoints, and hypothetical uncontrolled confounder assessment -- were consistent in this finding.

Prespecified subgroups according to device type, peripheral artery disease severity, procedure location, and patient characteristics also upheld the safety of drug-coated devices.

NODE-301

The novel L-type calcium channel blocker etripamil was found to relieve paroxysmal supraventricular tachycardia (PSVT) symptoms in a small placebo-controlled trial. It also came close to significantly reducing rescue medical interventions for PSVT.

Etripamil is designed to be used as a self-administered nasal spray. Previously, the drug had failed to show efficacy versus placebo for rapid termination of atrioventricular nodal-dependent PSVT events outside the emergency department or hospital.

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