Risk of Major Adverse Cardiovascular Events After SARS-CoV-2 Infection in British Columbia: A Population-Based Study - 11/02/25
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Abstract |
Background |
COVID-19 is associated with increased risk of post-acute cardiovascular outcomes. Population-based evidence for long periods of observation is still limited.
Methods |
This population-based cohort study was conducted using data (2020-2021) from the British Columbia COVID-19 Cohort. The exposure of interest was severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, identified through reverse transcription–polymerase chain reaction (RT-PCR) assay. Individuals who tested positive (exposed) on RT-PCR were matched to negative controls (unexposed) on sex, age, and RT-PCR collection date in a 1:4 ratio. Outcomes of interest were incident major adverse cardiovascular events and acute myocardial infarction, identified more than 30 days after RT-PCR collection date. The association between SARS-CoV-2 infection and cardiovascular risk was assessed through multivariable survival models. Population attributable fractions were computed from Cox models.
Results |
We included 649,320 individuals: 129,864 exposed and 519,456 unexposed. The median duration of follow-up was 260 days; 1,786 events (0.34%) took place among the unexposed, and 702 (0.54%) in the exposed. The risk of major adverse cardiovascular events was higher in the exposed (adjusted hazard ratio [aHR] 1.34; 95% confidence interval [CI], 1.22-1.46), with greater risk observed in those who were hospitalized (aHR 3.81; 95% CI, 3.12-4.65) or required intensive care unit admission (aHR 6.25; 95% CI, 4.59-8.52) compared with the unexposed group. The fraction of cardiovascular events attributable to SARS-CoV-2 was 7.04% (95% CI, 4.67-9.41%). Comparable results were observed for acute myocardial infarction.
Conclusions |
SARS-CoV-2 infection was associated with higher cardiovascular risk, with graded increase across the acute COVID-19 severity, contributing to 7% of incident major adverse cardiovascular events. These findings suggest that long-term monitoring of cardiovascular risk is required in COVID-19 survivors.
El texto completo de este artículo está disponible en PDF.Key Words : Long COVID, cardiovascular risk, survival analysis, population-based cohort
Esquema
| Funding: This work was supported by the British Columbia Centre for Disease Control and the Canadian Institutes of Health Research [Grants #VR5-172683 and #OV4-170361]. The funders were not involved at any stage in study design, data collection, data analysis, data interpretation, writing of the report, or the decision of where to publish. |
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| Conflicts of Interest: NZJ participated in advisory boards and has spoken for AbbVie and Gilead, on matters not related to current work. Other authors declare that they have no conflicts of interest. |
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| Authorship: HAVG: Writing – review & editing, original draft, Methodology, Formal analysis, Data curation, Conceptualization; SW: Writing – review & editing, Data curation, Methodology; DJ: Writing – review & editing; MB: Writing – review & editing; ZN: Writing – review & editing; JW: Writing – review & editing; NMH: Writing – review & editing; NZJ: Writing – original draft, review & editing, Supervision, Project administration, Methodology, Funding acquisition, Formal analysis, Conceptualization. All authors have read and agreed to submit the final form of the manuscript. |
Vol 138 - N° 3
P. 524 - mars 2025 Regresar al número
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