Let’s reverse the course. Because we risk a tremendous return to the past, destined to result in an excess of deaths from cardiovascular disease. It is a real alarm that the experts of the Italian Society of Cardiology (Sic), to design a future that does not see us go back dramatically. What happened in time of the Covid-19 pandemic in Italy is revealed by a survey of 45 hospitals equally distributed throughout the country, which indicates how dramatically there has been a reversal.
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68% of hospitals reduced elective admissions for heart patients, 50% decreased the supply of diagnostic tests, and 45% had to cut outpatient visits. 22% even had to reduce the number of beds in intensive cardiac care (Utic), while 18% of the hospitals reduced the medical staff in Utic and 13% the nursing staff. Faced with a virus that can also attack the heart and arteries and leave distant results, the fear of a resumption of mortality and in any case of worse prognosis for heart attacks, strokes and heart failure is well founded. The analysis monitored in two different phases, in November / December 2021 and then in January 2022, the activities in the cardiology field of 45 hospitals belonging to Sic. And they show a side effect of the pandemic on the hearts of the Italians that we will have to face.
Heart door
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“The omicron variant and the vaccine have significantly reduced the severe forms of Covid 19 and the need to end up in resuscitation, while the direct and indirect consequences of the pandemic on cardiovascular diseases are unfortunately still widely underestimated – he stresses. Ciro IndolfiPresident of the Italian Society of Cardiologiststo. The lack of planning in the previous months and the emergency decisions led to a health reorganization that penalized many cardiologies throughout the country: coronary angioplasty, percutaneous implantation of heart valves, procedures for the implantation of pacemakers and defibrillators decreased , ablations; electrocardiograms, echocardiography and exercise tests were reduced “.
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In short. After so much has been done, there is a risk of a return to the past that must be absolutely avoided, because it could lead to a downsizing of assistance in the face of potential growing requests from people. Indeed, the pandemic has certainly not changed the risk profile of men and women for the better. The figures say it. “Today there are 1 million more smokers than in the past, 44% of Italians have gained weight, excessive alcohol consumption has grown by 23.6% among males and 9.7% among women – he points out Pasquale Perrone FilardiPresident elected of the SIC. These data are very worrying and presage an increase in cardiovascular diseases in the coming years, to which is added the increase in ischemic heart diseases: Italy was the first Western nation to be affected by the pandemic and SIC was the first scientific society, in a study published onEuropean Heart Journalto intercept this phenomenon already in the first phase of the pandemic, when a threefold increase in mortality from myocardial infarction was recorded “.
Heart door
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How to counter this evolution, considering that in Italy cardiovascular diseases represent 44% of all deaths, ischemic heart disease is the main cause of death (28%) and 4.4 Italians per thousand suffer from cardiovascular disability? Some proposals come from an editorial published on Circulation that draws in chiaroscuro the today and above all the tomorrow of this challenge. To sign it are the same Ciro Indolfie Giovanni Espositopresident of the Italian Society of Interventional Cardiology (GISE). “There is an apparent disparity between the standards of care provided in the different regions, especially as regards diagnoses or highly complex interventions in the south – this is the first point underlined. It is then necessary to resolve the heterogeneity in the number and in the relationships between hospitals in the different areas. public and private or accredited hospitals and finally it is necessary to face financial cuts of over 37 billion euros to the National Health System, with a forecast that public health expenditure will fall from 6.6% to 6.4% of gross domestic product in 2022 “. According to what the specialists indicate, it makes sense to focus on funding from the Recovery Fund of the European Commission to renovate the infrastructure of large hospitals (with particular attention to the distribution of technologies on the territory), to develop better management of chronic diseases and to support self-sufficiency at home also thanks to telemedicine. And then, you have to believe in research. Again in Circulation we read that in Italy “funding for cardiovascular research comes from the Ministry of Scientific Research and Health. Despite the high quality of Italian cardiological research, the funds for research are insufficient. In 14 years, this value is ranged from 1% to 1.4% of gross domestic product, while the European Union average is 2%. It is clear that Italian institutions should invest more in development and research “.
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