Exploring in-hospital clinical outcomes among acute myocardial infarction patients with prior COVID-19 history

TL;DR

This study finds that prior severe COVID-19 is linked to worse heart outcomes in patients with acute myocardial infarction, especially in younger individuals.

Contribution

The study provides real-world data on cardiovascular outcomes in post-COVID-19 patients, focusing on the Asian Indian population.

Findings

Patients with prior severe COVID-19 had higher rates of in-hospital cardiac arrest, stroke, and death.

Unadjusted odds ratios showed increased risk for MACE in those with prior COVID-19.

After adjusting for comorbidities, the increased risk of MACE was no longer significant.

Abstract

Limited real-world data exist regarding cardiovascular outcomes in post-COVID-19 individuals following discharge, particularly within the Asian Indian population. This study aims to explore the association between prior COVID-19 history and in-hospital outcomes in acute myocardial infarction patients.

Hospital database was searched for the patients who were diagnosed with Acute myocardial infarction (AMI) and were grouped according to absence (Group-A) or presence (Group-B) of history of severe COVID-19 hospitalization at least 3 months prior to the index event of AMI. Study primary endpoint was defined as major adverse cardiovascular events (MACE) comprising of Re-AMI, stroke, death (3P) and acute decompensated heart failure (4P), which were analyzed between these 2 study groups.

Of 10,581 consecutive patients of AMI, 5.33% (n=564/10,581) patients had prior history of severe SARS-CoV-2 hospitalization beyond 3 months of index AMI. Past severe Covid-19 patients presenting with AMI were more likely to be younger (59.12+11.23 years vs. 52.01+10.05 years) and younger than 40 years of age. Patients in Group B demonstrated a notably higher prevalence of diabetes, hypertension, higher Killip class, and lower presenting LVEF compared to Group A. In-hospital cardiac arrest, stroke, heart failure and all-cause death were significantly higher in Group B patients. Higher unadjusted odds ratio for in hospital death OR=5.78 (2.56-10.23), 3-P MACE OR=2.33 (1.23-8.65) and 4-P MACE OR=2.58 (1.36-5.43) were found in patients with prior history of COVID-19. After adjusting for comorbidities, the ratio for in-hospital MACE was found to be non-significant.

Conventional risk factors and presence of comorbidities in individuals with prior history of COVID-19 hospitalization increased the risk of both 3P and 4P MACE during AMI.

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