tetano
Editor, Senior Moderator
Thromb Haemost
. 2023 May 5.
doi: 10.1055/a-2087-3003. Online ahead of print. Risk factors for post-discharge major thromboembolism and mortality in hospitalized patients with COVID-19 with cardiovascular comorbidities
Dimitrios Giannis[SUP] 1 [/SUP], Mark Goldin[SUP] 2 [/SUP], Husneara Rahman[SUP] 1 [/SUP], Cristina P Sison[SUP] 1 3 [/SUP], Martin Lesser[SUP] 4 [/SUP], Sam Ngu[SUP] 5 [/SUP], James Tsang[SUP] 5 [/SUP], Michael Qiu[SUP] 5 3 [/SUP], Shreya Sanghani[SUP] 5 3 [/SUP], Jackson Yeh[SUP] 5 3 [/SUP], Miltiadis Matsagkas[SUP] 6 [/SUP], Eleni Arnaoutoglou[SUP] 6 [/SUP], Alex C Spyropoulos[SUP] 7 [/SUP]
Affiliations
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.
. 2023 May 5.
doi: 10.1055/a-2087-3003. Online ahead of print. Risk factors for post-discharge major thromboembolism and mortality in hospitalized patients with COVID-19 with cardiovascular comorbidities
Dimitrios Giannis[SUP] 1 [/SUP], Mark Goldin[SUP] 2 [/SUP], Husneara Rahman[SUP] 1 [/SUP], Cristina P Sison[SUP] 1 3 [/SUP], Martin Lesser[SUP] 4 [/SUP], Sam Ngu[SUP] 5 [/SUP], James Tsang[SUP] 5 [/SUP], Michael Qiu[SUP] 5 3 [/SUP], Shreya Sanghani[SUP] 5 3 [/SUP], Jackson Yeh[SUP] 5 3 [/SUP], Miltiadis Matsagkas[SUP] 6 [/SUP], Eleni Arnaoutoglou[SUP] 6 [/SUP], Alex C Spyropoulos[SUP] 7 [/SUP]
Affiliations
- PMID: 37146648
- DOI: 10.1055/a-2087-3003
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.