tetano
Editor, Senior Moderator
Open Heart
. 2020 Nov;7(2):e001428.
doi: 10.1136/openhrt-2020-001428.
Coronary artery disease in patients hospitalised with Coronavirus disease 2019 (COVID-19) infection
Marco Loffi[SUP] #[/SUP][SUP] 1 [/SUP], Raffaele Piccolo[SUP] #[/SUP][SUP] 2 [/SUP], Valentina Regazzoni[SUP] 3 [/SUP], Giuseppe Di Tano[SUP] 3 [/SUP], Luigi Moschini[SUP] 3 [/SUP], Debora Robba[SUP] 3 [/SUP], Filippo Quinzani[SUP] 3 [/SUP], Giovanni Esposito[SUP] 4 [/SUP], Anna Franzone[SUP] 2 [/SUP], Gian Battista Danzi[SUP] 3 [/SUP]
Affiliations
Abstract
Objective: Among patients with Coronavirus disease 2019 (COVID-19), coronary artery disease (CAD) has been identified as a high-risk condition. We aimed to assess the clinical outcomes and mortality among patients with COVID-19 according to CAD status.
Methods: We retrospectively analysed data from patients with COVID-19 admitted to the Cremona Hospital (Lombardy region, Italy) between February and March 2020. The primary outcome was all-cause mortality. CAD was defined as a history of prior myocardial infarction (MI), prior percutaneous coronary intervention (PCI), prior coronary artery bypass grafting (CABG) or CAD that was being medically treated.
Results: Of 1252 consecutive patients with COVID-19, 124 (9.9%) had concomitant CAD. Patients with CAD were older and had a higher prevalence of comorbidities compared with those without CAD. Although patients with CAD had a higher risk of all-cause mortality than patients without CAD (HR 3.01, 95% CI 2.27 to 3.99), this difference was no longer significant in the adjusted model (HR 1.14, 95% CI 0.79 to 1.63). Results were consistent among patients with prior MI (adjusted HR (aHR) 0.87, 95% CI 0.54 to 1.41), prior PCI (aHR 1.10, 95% CI 0.75 to 1.62), prior CABG (aHR 0.91, 95% CI 0.45 to 1.82), or CAD medically treated (aHR 0.84, 95% CI 0.29 to 2.44). Multivariable analysis showed that age (aHR per 5 year increase 1.62, 95% CI 1.53 to 1.72) and female sex (aHR 0.63, 95% CI 0.49 to 0.82) were the only two independent correlates of mortality.
Conclusion: Patients with COVID-19 and CAD have an exceedingly higher risk of mortality, which is mainly attributable to the burden of comorbidities rather than to a direct effect of CAD per se.
Keywords: atherosclerosis; coronary artery disease; risk stratification.
. 2020 Nov;7(2):e001428.
doi: 10.1136/openhrt-2020-001428.
Coronary artery disease in patients hospitalised with Coronavirus disease 2019 (COVID-19) infection
Marco Loffi[SUP] #[/SUP][SUP] 1 [/SUP], Raffaele Piccolo[SUP] #[/SUP][SUP] 2 [/SUP], Valentina Regazzoni[SUP] 3 [/SUP], Giuseppe Di Tano[SUP] 3 [/SUP], Luigi Moschini[SUP] 3 [/SUP], Debora Robba[SUP] 3 [/SUP], Filippo Quinzani[SUP] 3 [/SUP], Giovanni Esposito[SUP] 4 [/SUP], Anna Franzone[SUP] 2 [/SUP], Gian Battista Danzi[SUP] 3 [/SUP]
Affiliations
- PMID: 33229434
- DOI: 10.1136/openhrt-2020-001428
Abstract
Objective: Among patients with Coronavirus disease 2019 (COVID-19), coronary artery disease (CAD) has been identified as a high-risk condition. We aimed to assess the clinical outcomes and mortality among patients with COVID-19 according to CAD status.
Methods: We retrospectively analysed data from patients with COVID-19 admitted to the Cremona Hospital (Lombardy region, Italy) between February and March 2020. The primary outcome was all-cause mortality. CAD was defined as a history of prior myocardial infarction (MI), prior percutaneous coronary intervention (PCI), prior coronary artery bypass grafting (CABG) or CAD that was being medically treated.
Results: Of 1252 consecutive patients with COVID-19, 124 (9.9%) had concomitant CAD. Patients with CAD were older and had a higher prevalence of comorbidities compared with those without CAD. Although patients with CAD had a higher risk of all-cause mortality than patients without CAD (HR 3.01, 95% CI 2.27 to 3.99), this difference was no longer significant in the adjusted model (HR 1.14, 95% CI 0.79 to 1.63). Results were consistent among patients with prior MI (adjusted HR (aHR) 0.87, 95% CI 0.54 to 1.41), prior PCI (aHR 1.10, 95% CI 0.75 to 1.62), prior CABG (aHR 0.91, 95% CI 0.45 to 1.82), or CAD medically treated (aHR 0.84, 95% CI 0.29 to 2.44). Multivariable analysis showed that age (aHR per 5 year increase 1.62, 95% CI 1.53 to 1.72) and female sex (aHR 0.63, 95% CI 0.49 to 0.82) were the only two independent correlates of mortality.
Conclusion: Patients with COVID-19 and CAD have an exceedingly higher risk of mortality, which is mainly attributable to the burden of comorbidities rather than to a direct effect of CAD per se.
Keywords: atherosclerosis; coronary artery disease; risk stratification.