CV Testing Declined Across Asia During COVID Pandemic

JACC: Asia study shows further impact of pandemic on vital health services, including life-saving CVD diagnostics

Contact: Nicole Napoli,, 202-375-6523

WASHINGTON (Sep 21, 2021) -

Diagnostic cardiovascular procedures declined an average of 47% in Asia in March 2020 compared to March 2019, with the greatest declines seen in low-income countries—some of which saw up to 80% declines, according to research published in JACC: Asia looking at the impact of the COVID-19 pandemic on cardiovascular care.

“The rapid global spread of COVID-19 has changed the global economy and social environment and has had a negative impact on routine medical practice, particularly the diagnostic evaluation of cardiovascular disease,” said Takashi Kudo, MD, PhD, lead author of the study and professor, Department of Radioisotope Medicine, Atomic Bomb Disease, Nagasaki University, Nagasaki, Japan. “Further study is warranted to determine the impact of the COVID-19 pandemic on cardiovascular disease morbidity and mortality, as well as to develop strategies to maintain essential health care services like cardiac diagnostics in a resurgence of COVID-19 or in future pandemics.”

Cardiovascular disease (CVD) is the leading cause of death worldwide, but the emphasis on early diagnosis and treatment by clinicians has significantly reduced the rate of death and incidence of major cardiovascular events. However, according to researchers, the COVID-19 pandemic holds potential to halt that progress by delaying the advanced diagnostic procedures that detect and determine treatment of CVD.

In this study, data was analyzed from the International Atomic Energy Agency Division of Human Health Non-invasive Cardiology Protocols of COVID study (INCAPS COVID), the first study to look at the impact of COVID-19 on CVD procedural volumes, to conduct a sub-study evaluating the effects of the early phase of the COVID-19 pandemic on cardiovascular diagnostic procedures and safety practices in Asia, the first region impacted by COVID-19.

Testing volumes were reported for March and April 2020 and compared to those from March 2019. Data from 180 centers across 33 Asian countries were grouped into four sub-regions for comparison. Researchers found that procedure volumes decreased by 47% from March 2019 to March 2020, but Eastern Asia, particularly China, saw early recovery of the decline from March 2020 to April 2020. The most severe reductions in procedure volumes were observed in lower income countries, where volumes decreased 80% from March 2019 to April 2020. The majority of the centers looked at had implemented COVID-19 protocols that included canceling outpatient activities, increasing time per study to allow for cleaning and disinfecting, implementing physical distancing and restricting visitors, all of which contributed to procedural declines.

In a related editorial comment, Pranav M. Patel, MD, FACC, Chief, Division of Cardiology, University of California, Irvine, said there is hope that although there was initial chaos around global cardiovascular testing in the early days of the pandemic, later responses show that countries and policies are becoming more harmonious.

“These new challenges with the pandemic are improving our skills and teaching us how to enhance cardiovascular care,” Patel said. “As with the current study, we should also encourage further research until we truly understand the global impact of this pandemic on the cardiovascular care of our patients.”

The paper published in the JACC: Asia, the first region-specific cardiovascular journal with original peer-reviewed content. The publication is an online-only open access journal covering topics ranging from cardiovascular health and prevention to late-stage interventions specifically within East Asian populations. The journal also features clinical practice guideline recommendations focused on Chinese, Japanese and South Korean patients who have or are at risk of developing cardiovascular disease.

Other manuscripts published in the September issue include:

  • 2021 Consensus Pathway of Taiwan Society of Cardiology on Novel Therapy for Type 2 Diabetes
  • Validation of the Khorana venous thromboembolism risk score in Japanese cancer patients
  • The Use of Machine Learning for the Care of Hypertension and Heart Failure

Learn more about JACC: Asia at

For a copy of any of the papers in JACC: Asia, contact Nicole Napoli,

The American College of Cardiology envisions a world where innovation and knowledge optimize cardiovascular care and outcomes. As the professional home for the entire cardiovascular care team, the mission of the College and its 54,000 members is to transform cardiovascular care and to improve heart health. The ACC bestows credentials upon cardiovascular professionals who meet stringent qualifications and leads in the formation of health policy, standards and guidelines. The College also provides professional medical education, disseminates cardiovascular research through its world-renowned JACC Journals, operates national registries to measure and improve care, and offers cardiovascular accreditation to hospitals and institutions. For more, visit

The ACC’s family of JACC Journals rank among the top cardiovascular journals in the world for scientific impact. The flagship journal, the Journal of the American College of Cardiology (JACC) — and family of specialty journals consisting of JACC: Advances, JACC: Asia, JACC: Basic to Translational Science, JACC: CardioOncology, JACC: Cardiovascular Imaging, JACC: Cardiovascular Interventions, JACC: Case Reports, JACC: Clinical Electrophysiology and JACC: Heart Failure — pride themselves on publishing the top peer-reviewed research on all aspects of cardiovascular disease. Learn more at


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