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BACKGROUND: We aimed to study the effect of social containment mandates on ACS presentation during COVID-19 pandemic using location activity and mobility data from mobile phone map services. METHODS: We conducted a cross-sectional study using data from the Swedish Coronary Angiography and Angioplasty Registry (SCAAR) including all ACS presentations during the pandemic until May 07, 2020. Using a count regression model, we adjusted for day of the week, daily weather, and incidence of COVID-19. RESULTS: A 10% increase in activity around areas of residence was associated with 38% lower rates of ACS hospitalisations whereas increased activity relating to retail and recreation, grocery stores and pharmacies, workplaces as well as mode of mobility was associated with 10-20% higher rates of ACS hospitalisations. CONCLUSION: Government policy regarding social containment mandates has important public health implications for medical emergencies like ACS and may explain the decline in ACS presentations observed during COVID-19 pandemic.

Funding Support and Author Disclosures This work was supported by grants from The Swedish Heart-Lung Foundation (20180560 to Dr Jeppsson and 201604 to Dr Nielsen), The Swedish state under the agreement between the Swedish government and the county councils concerning economic support of research and education of doctors (ALF agreement) (ALFGBG-725131 to Dr Jeppsson), and Västra Götaland Region (VGFOUREG-847811 and VGFOUREG-665591 to Dr Jeppsson), and Family Nils Winberg's Foundation. The supporting bodies had no influence on the analysis and interpretation of data, on the writing of the report, or on the decision to submit the paper for publication. Dr Omerovic has received an institutional research grant from AstraZeneca; has received consultancy fees from Bayer and Novartis; and has received speaker honorarium from Merck, Sharp & Dohme, all outside the present work. Dr Dellgren has received an institutional grant for the SweVAD study from Abbott; and has received an institutional grant for the ScanCLAD study from Astellas. Dr Dellgren has received speaker's fees from XVIVO, all outside the present work. Dr Milojevic has received speaker's fees from LivaNova outside the present work. Dr Jeppsson has received fees for consultancy or lectures from Werfen, Boehringer Ingelheim, Portola, Baxter, and LFB Biomedicaments, all unrelated to the present work. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. Publisher Copyright: © 2021 The Authors ; Background: Surgical risk, age, perceived life expectancy, and valve durability influence the choice between surgical aortic valve replacement (SAVR) and transcatheter aortic valve implantation. The contemporaneous life expectancy after SAVR, in relation to surgical risk and age, is unknown. Objectives: The purpose of this study was to determine median survival time in relation to surgical risk and chronological age in SAVR patients. Methods: Patients ≥60 years with aortic stenosis who underwent isolated ...

Aims Ischaemic coronary artery disease (CAD) remains the leading cause of mortality globally due to sudden death and heart failure (HF). Invasive coronary angiography (CAG) is the gold standard for evaluating the presence and severity of CAD. Our objective was to assess temporal trends in CAG utilization, patient characteristics, and prognosis in HF patients undergoing CAG at a national level. Methods and results We used data from the Swedish Coronary Angiography and Angioplasty Registry. Data on all patients undergoing CAG for HF indication in Sweden between 2000 and 2018 were collected and analysed. Long-term survival was estimated with multivariable Cox proportional hazards regression adjusted for differences in patient characteristics. In total, 22 457 patients (73% men) with mean age 64.2 ± 11.3 years were included in the study. The patients were increasingly older with more comorbidities over time. The number of CAG specifically for HF indication increased by 5.5% per calendar year (P50% diameter stenosis in one or more coronary arteries (HF-CAD). The median follow-up time was 3.6 years in HF-CAD and 5 years in HF-NCAD. Age and sex-adjusted survival improved linearly by 1.3% per calendar year in all patients. Compared with HF-NCAD, long-term mortality was higher in HF-CAD patients. The risk of death increased with the increasing severity of CAD. Compared with HF-NCAD, the risk estimate in patients with a single-vessel disease was higher [hazard ratio (HR) 1.3; 95% confidence interval (CI) 1.20-1.41; P<0.0011, a multivessel disease without the involvement of left main coronary artery (HR 1.72; 95% C11.58-1.88; P < 0.001), and with left main disease (HR 2.02; 95% CI 1.88-2.18; P < 0.001). The number of HF patients undergoing revascularization with percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) increased by 7.5% (P < 0.001) per calendar year. The majority (53.4%) of HF-CAD patients were treated medically, while a minority (46.6%) were referred for revascularization with PCI or CABG. Compared with patients treated with PCI, the proportion of patients treated medically or with CABG decreased substantially (P<0.001). Conclusions Over 18 years, the number of patients with HF undergoing CAG has increased substantially. Expanded utilization of CAG increased the number of HF patients treated with percutaneous coronary intervention and coronary artery bypass surgery. Long-term survival improved in all HF patients despite a steady increase of elderly patients with comorbidities. ; Funding Agencies: Swedish Heart Lung Foundation; Swedish Research Council; Swedish federal government under the ALF agreement; Sahlgrenska Akademin; Västra Götalandsregionen

Acknowledgements S.H. acknowledges the support from the Netherlands Cardiovascular Research Initiative, an initiative with support of the Dutch Heart Foundation, CVON2016-Early HFPEF, 2015-10, and CVON She-PREDICTS, grant 2017-21, CVON-Arena-PRIME, European Union Commission's Seventh Framework programme under grant agreement n. 305507 (HOMAGE) and n. 602904 (FIBROTAR-GETS). D.D. acknowledges support from the British Heart Foundation grants PG/15/108/31928 and FS/16/39/32174, the Josephine Lansdell British Medical Association 2015Award and Tenovus Scotland, G13.10. A.R.L. is supported by the Leducq Foundation Cardio-Oncology Network. Conflict of interest: none declared ; Peer reviewed ; Publisher PDF