Thrombotic risk trajectories in patients with coronary artery disease before and during COVID-19

This study evaluated the thrombotic risk associated with SARS-CoV-2 infection among hospitalized patients with angiographically confirmed coronary artery disease (CAD). A prospective cohort design was used, including 2,078 CAD patients without coronavirus disease 2019 (COVID-19) admitted between January and April 2021 and 2,105 CAD patients with COVID-19 admitted between December 2022 and March 2023. The primary outcome was a composite of major thrombotic events. Patients with COVID-19 showed higher event incidence during 12-month follow-up (7.27% vs. 3.75%), with an adjusted hazard ratio (aHR) of 2.24. The risk was markedly elevated in the first 3 months after infection (hazard ratio [HR] 7.77), then declined but remained above baseline through 12 months. The findings indicate that SARS-CoV-2 infection is associated with a distinct temporal increase in thrombotic vulnerability among CAD patients, highlighting an early period of heightened risk that may inform post-infection monitoring strategies.