Increased risk of acute myocardial infarction after COVID-19 recovery: A systematic review and meta-analysis
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Marco Zuin1, Gianluca Rigatelli2, Valentina Battisti3
1Department of Cardiology, West Vicenza Hospital, Arzignano, Italy; Department of Translational Medicine, University of Ferrara, Ferrara, Italy.
Background:
Few studies have analyzed the incidence and the risk of acute myocardial infarction (AMI) during the post-acute phase of COVID-19 infection.
Objective:
To assess the incidence and risk of AMI in COVID-19 survivors after SARS-CoV-2 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 September 1, 2022 and reporting the risk of incident AMI in patients recovered from COVID-19 infection. AMI risk was evaluated using the Mantel-Haenszel random effects models with Hazard ratio (HR) as the effect measure with 95% confidence interval (CI) while heterogeneity was assessed using Higgins and Thomson I2 statistic.
Results:
Among 2765 articles obtained by our search strategy, four studies fulfilled the inclusion criteria for a total of 20,875,843 patients (mean age 56.1 years, 59.1% males). Of them, 1,244,604 had COVID-19 infection. Over a mean follow-up of 8.5 months, among COVID-19 recovered patients AMI occurred in 3.5 cases per 1.000 individuals compared to 2.02 cases per 1.000 individuals in the control cohort, defined as those who did not experience COVID-19 infection in the same period). COVID-19 patients showed an increased risk of incident AMI (HR: 1.93, 95% CI: 1.65-2.26, p < 0.0001, I2 = 83.5%). Meta-regression analysis demonstrated that the risk of AMI was directly associated with age (p = 0.01) and male gender (p = 0.001), while an indirect relationship was observed when the length of follow-up was utilized as moderator (p < 0.001).
Conclusion:
COVID-19 recovered patients had an increased risk of AMI.
Insights
COVID-19 survivors face a higher risk of acute myocardial infarction (AMI). This systematic review found a nearly twofold increased risk of AMI in individuals who recovered from COVID-19 infection.
Area of Science:
- Cardiology
- Infectious Diseases
- Epidemiology
Background:
- Limited research exists on acute myocardial infarction (AMI) risk post-COVID-19.
- Assessing AMI incidence in COVID-19 survivors is crucial for understanding long-term cardiovascular implications.
Approach:
- A systematic review and meta-analysis was conducted.
- Searched MEDLINE and Scopus for studies up to September 1, 2022.
- Analyzed incident AMI risk in COVID-19 recovered patients using Mantel-Haenszel random effects models.
Key Points:
- Four studies including over 20 million patients were analyzed.
- COVID-19 patients had a 1.93-fold increased risk of AMI (HR: 1.93, 95% CI: 1.65-2.26).
- AMI risk was associated with older age and male gender, and inversely related to follow-up duration.
Conclusions:
- COVID-19 recovery is linked to a significantly elevated risk of acute myocardial infarction.
- Findings highlight the need for cardiovascular monitoring in post-COVID-19 patients.
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