Abstract Background Deferral of non-emergency cardiac procedures is associated with increased early emergency cardiovascular hospitalizations. Criteria to identify patients at risk for adverse events when postponing their scheduled intervention are needed. Aim The aim of this study was to identify predictors associated with worse clinical outcome in cardiac patients whose non-emergency cardiovascular intervention has been deferred during the COVID-19 pandemic. Methods This monocentric retrospective study included patients whose non-emergency cardiac intervention has been postponed during COVID-19-related lockdown between March 19th and April 30th 2020. Cox regression was performed to identify predictors of the combined endpoint emergency cardiovascular hospitalization and death. Patients’ outcome after 12 months was compared to a seasonal control group undergoing non-emergency interventions in 2019 as scheduled. Results The combined endpoint of death and emergency cardiovascular hospitalization occurred in 70 (36.5%) of 193 patients with a postponed cardiovascular intervention. The planned intervention was deferred by a median of 23 [19 – 36] days. Arterial hypertension (Hazard ratio [HR] 2.27; 95%-Confidence interval [CI] 1.00-5.12; P=0.049), chronic kidney disease (HR 1.89; 95%-CI 1.03 – 3.49, P=0.041) as well as severe valvular heart disease (HR 3.08; 95%-CI 1.68-5.64; P<0.001) were independent predictors of death or emergency hospitalization. Kaplan-Maier estimators of the combined endpoint were 31% in patients with arterial hypertension, 56% in patients with severe valvular heart disease and 77% with both risk factors (HR 12.4, 95%-CI 3.8-40.7; P<0.001) and only 9% in patients without these risk factors (log rank P<0.001). Separate analyses of patients with arterial hypertension, chronic kidney disease and severe valvular heart disease revealed that deferred patients showed significantly poorer clinical outcomes when compared to the control group 2019 (log rank P<0.001, P=0.006 and P<0.001, respectively). NT-proBNP cut-off ≥ 1,109 pg/ml best predicts the occurrence of primary endpoint event in deferred patients (AUC 0.71; P<0.001; sensitivity 64%, specificity 69%). Conclusion Our results suggest that patients with either arterial hypertension, chronic kidney or severe valvular heart disease are at very high risk for emergency hospitalization and increased mortality in case of postponed cardiac interventions even in supposed stable clinical status. Risk is even higher in patients suffering from a combination of these conditions. In addition, measuring NT-proBNP levels might help to identify those at high or very high risk.