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Preexisting coronary artery disease among coronavirus disease 2019 patients: a systematic review and meta-analysis

Marco Zuin1, Gianluca Rigatelli2, Claudio Bilato3

  • 1Department of Translational Medicine, University of Ferrara, Ferrara.

Journal of Cardiovascular Medicine (Hagerstown, Md.)
|July 29, 2022
PubMed

Insights

Preexisting coronary artery disease (CAD) affects about 1 in 10 hospitalized COVID-19 patients. This condition significantly increases the risk of short-term mortality, influenced by factors like age and comorbidities.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Public Health

Background:

  • The prevalence and prognostic impact of coronary artery disease (CAD) in COVID-19 patients are not well understood.
  • Understanding this relationship is crucial for managing patients with both conditions.

Purpose of the Study:

  • To systematically review and analyze the prevalence of preexisting CAD in COVID-19 patients.
  • To assess the mortality risk associated with CAD in COVID-19 patients.

Main Methods:

  • A systematic review and meta-analysis of studies published up to December 8, 2021.
  • Searched Medline and Scopus for relevant articles.
  • Pooled data using Mantel-Haenszel random effects models to calculate odds ratios (OR) and 95% confidence intervals (CI).

Main Results:

  • Analyzed 38 studies with 27,435 patients.
  • Pooled prevalence of preexisting CAD was 12.6%, higher in ICU patients (17.5%) and European cohorts.
  • COVID-19 patients with CAD had a 2.61-fold increased risk of short-term mortality, with variations across geographic regions.
  • Age, hypertension, diabetes mellitus (DM), and chronic kidney disease (CKD) influenced the CAD-mortality association.

Conclusions:

  • Preexisting CAD is identified in approximately 10% of hospitalized COVID-19 patients.
  • CAD is significantly associated with increased short-term mortality risk in COVID-19 patients.
  • This increased risk is modulated by age and the presence of comorbidities such as hypertension, DM, and CKD.
Abstract

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