Increased risk of acute myocardial infarction after COVID-19 recovery: A systematic review and meta-analysis

Zuin, Marco; Rigatelli, Gianluca; Battisti, Valentina; Costola, Giulia; Roncon, Loris; Bilato, Claudio

doi:10.1016/j.ijcard.2022.12.032

Cited by 42 publications

(33 citation statements)

References 28 publications

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“…16 Subsequently, a recently published retrospective observational 19 Data from a recent meta-analysis of 7,816 discharged patients with COVID-19 showed an ATE rate of 1.46% for a postdischarge follow-up period of up to 6 months among the included studies, while another large meta-analysis of 20,875,843 patients in the postacute phase of COVID-19 showed a cumulative postdischarge rate of incident MI between 0.1 and 1.1% with a mean follow-up of 8.5 months. 20,30 Lastly, the REMAP-CAP trial in hospitalized severe COVID-19 patients showed a benefit on 90-day mortality, at the cost of a significantly increased risk of MB in patients receiving antiplatelets (OR ¼ 2.97; 95% CI, 1.23-8.28). 31 The observed benefit of antiplatelet therapy at 90 days and the persistently increased risk of arterial thromboses for several months after the diagnosis of COVID-19 indicate the need for well-designed trials investigating the risks and benefits of antiplatelets in the postdischarge period.…”

Section: Ate Vte or Acm: Univariate Analysismentioning

confidence: 99%

Risk Factors for Postdischarge Major Thromboembolism and Mortality in Hospitalized Patients with COVID-19 with Cardiovascular Comorbidities: Insights from the CORE-19 Registry

et al. 2023

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Background Coronavirus disease 2019 (COVID-19) is associated with venous and arterial thromboembolism (VTE and ATE) and all-cause mortality (ACM) in hospitalized patients. High-quality data are needed on post-discharge outcomes in patients with cardiovascular disease. Objectives To analyze outcomes and identify risk factors for ATE, VTE, and ACM in a high-risk subgroup of hospitalized COVID-19 patients with baseline cardiovascular disease. Methods We investigated post-discharge rates and associated risk factors of ATE, VTE, and ACM in 608 hospitalized COVID-19 patients with coronary artery disease (CAD), carotid artery stenosis (CAS), peripheral arterial disease (PAD), or ischemic stroke. Results Through 90 days post-discharge, outcome rates were: ATE 27.3% (10.2% myocardial infarction, 10.1% ischemic stroke, 13.2% systemic embolism, 12.7% major adverse limb event); VTE 6.9% (4.1% deep vein thrombosis, 3.6% pulmonary embolism); composite of ATE, VTE, or ACM 35.2% (214/608). Multivariate analysis showed significant association between this composite endpoint and age > 75 years (odds ratio [OR]: 1.90, 95% confidence interval [CI]: 1.22-2.94, p = 0.004), PAD (OR: 3.23, 95% CI: 1.80-5.81, p = < 0.0001), CAS (OR: 1.74, 95% CI: 1.11-2.75, p = 0.017), congestive heart failure (CHF) (OR: 1.84, 95% CI: 1.02-3.35, p = 0.044), previous VTE (OR: 3.08, 95% CI: 1.75-5.42, p < 0.0001), and intensive care unit (ICU) admission (OR: 2.93, 95% CI: 1.81-4.75, p < 0.0001). Conclusions COVID-19 inpatients with cardiovascular disease experience high rates of ATE, VTE, or ACM through 90 days post-discharge. Age > 75 years, PAD, CAS, CHF, previous VTE, and ICU admission are independent risk factors.

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Section: Ate Vte or Acm: Univariate Analysismentioning

confidence: 99%

Risk Factors for Postdischarge Major Thromboembolism and Mortality in Hospitalized Patients with COVID-19 with Cardiovascular Comorbidities: Insights from the CORE-19 Registry

et al. 2023

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“…Since the beginning of COVID-19 outbreak, arterial hypertension (HT) was recognized as one of the most common comorbidities in COVID-19 patients as well as an independent predictor of short-term mortality and severe disease [1][2][3][4]. Recent analyses have demonstrated an increased risk of cardiovascular sequelae after COVID-19 recovery compared to the general population not exposed to SARS-CoV-2 infection [5][6][7][8][9]. However, data regarding the risk of development new-onset HT as a post-acute COVID-19 sequelae remain scant.…”

Section: Introductionmentioning

confidence: 99%

Risk of Incident New-Onset Arterial Hypertension After COVID-19 Recovery: A Systematic Review and Meta-analysis

Zuin

Rigatelli

Bilato³

et al. 2023

High Blood Press Cardiovasc Prev

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Introduction Arterial Hypertension (HT) has been described as a common comorbidity and independent risk factor of short-term outcome in COVID-19 patients. However, data regarding the risk of new-onset HT during the post-acute phase of COVID-19 are scant. Aim We assess the risk of new-onset HT in COVID-19 survivors within one year from the index infection by a systematic review and meta-analysis of the available data. Methods Data were obtained searching MEDLINE and Scopus for all studies published at any time up to February 11, 2023, and reporting the long-term risk of new-onset HT in COVID-19 survivors. Risk data were pooled using the Mantel–Haenszel random effects models with Hazard ratio (HR) as the effect measure with 95% confidence interval (CI). Heterogeneity among studies was assessed using I 2 statistic. Results Overall, 19,293,346 patients (mean age 54.6 years, 54.6% males) were included in this analysis. Of them, 758,698 survived to COVID-19 infection. Over a mean follow-up of 6.8 months, new-onset HT occurred to 12.7 [95% CI 11.4–13.5] out of 1000 patients survived to COVID-19 infection compared to 8.17 [95% CI 7.34–8.53] out of 1000 control subjects. Pooled analysis revealed that recovered COVID-19 patients presented an increased risk of new-onset HT (HR 1.70, 95% CI 1.46–1.97, p < 0.0001, I 2 = 78.9%) within seven months. This risk was directly influenced by age (p = 0.001), female sex (p = 0.03) and cancer (p < 0.0001) while an indirect association was observed using the follow-up length as moderator (p < 0.0001). Conclusions Our findings suggest that new-onset HT represents an important post-acute COVID-19 sequelae. Supplementary Information The online version contains supplementary material available at 10.1007/s40292-023-00574-5.

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“…Another issue that has come to light during the pandemic is that of long-term cardiovascular and neurological consequences [ 3 ]. In particular, among patients convalescing from COVID-19, a greater risk of developing myocardial infarction (MI) has been demonstrated [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Targeted Blood Plasma Proteomics and Hemostasis Assessment of Post COVID-19 Patients with Acute Myocardial Infarction

Kalinskaya

Vorobyeva

Rusakovich

et al. 2023

IJMS

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The molecular mechanisms underlying cardiovascular complications after the SARS-CoV-2 infection remain unknown. The goal of our study was to analyze the features of blood coagulation, platelet aggregation, and plasma proteomics in COVID-19 convalescents with AMI. The study included 66 AMI patients and 58 healthy volunteers. The groups were divided according to the anti-N IgG levels (AMI post-COVID (n = 44), AMI control (n = 22), control post-COVID (n = 31), and control (n = 27)). All participants underwent rotational thromboelastometry, thrombodynamics, impedance aggregometry, and blood plasma proteomics analysis. Both AMI groups of patients demonstrated higher values of clot growth rates, thrombus size and density, as well as the elevated levels of components of the complement system, proteins modifying the state of endothelium, acute-phase and procoagulant proteins. In comparison with AMI control, AMI post-COVID patients demonstrated decreased levels of proteins connected to inflammation and hemostasis (lipopolysaccharide-binding protein, C4b-binding protein alpha-chain, plasma protease C1 inhibitor, fibrinogen beta-chain, vitamin K-dependent protein S), and altered correlations between inflammation and fibrinolysis. A new finding is that AMI post-COVID patients opposite the AMI control group, are characterized by a less noticeable growth of acute-phase proteins and hemostatic markers that could be explained by prolonged immune system alteration after COVID-19.

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Increased risk of acute myocardial infarction after COVID-19 recovery: A systematic review and meta-analysis

Cited by 42 publications

References 28 publications

Risk Factors for Postdischarge Major Thromboembolism and Mortality in Hospitalized Patients with COVID-19 with Cardiovascular Comorbidities: Insights from the CORE-19 Registry

Risk Factors for Postdischarge Major Thromboembolism and Mortality in Hospitalized Patients with COVID-19 with Cardiovascular Comorbidities: Insights from the CORE-19 Registry

Risk of Incident New-Onset Arterial Hypertension After COVID-19 Recovery: A Systematic Review and Meta-analysis

Targeted Blood Plasma Proteomics and Hemostasis Assessment of Post COVID-19 Patients with Acute Myocardial Infarction

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