Abstract 17286: Ninety-Day Adjudicated Cardiovascular Events in Patients With Covid-19: Association With Vaccination Status and Changes Over Time in the Corona-VTE Network Study
Behnood Bikdeli, Antoine Bejjani, Candrika D Khairani, Darsiya Krishnathasan, Julia Davies, Nicole D Porio, Anthony Tristani, Andre Armero, Ali Assi, Victor Nauffal, Umberto Cambia, Zaid Almarzooq, Eric Wei, Aditya Achanta, Sirus Jesudasen, Bruce Tiu, Geno J Merli, Orly Leiva, John Fanikos, Aditya Sharma, Alec Vishnevsky, Judith A Hsia, Mark Nehler, James Welker, Marc P Bonaca, Brett Carroll, ZHou Lan, Samuel Goldhaber, Gregory Piazza- Physiology (medical)
- Cardiology and Cardiovascular Medicine
Background: Coronavirus disease 2019 (COVID-19) is associated with excess risk of cardiovascular events. Despite the progress in our understanding of cardiovascular complications, uncertainty persists with respect to contemporary event rates, and the association between use of vaccines and outcomes, and changes in incidence rates over time.
Methods: Adult patients with polymerase chain reaction-confirmed COVID-19 who received care at Mass General-Brigham health system, Beth Israel Deaconess Medical Center, Anne Arundel Medical Center, University of Virginia Medical Center, University of Colorado Health System, and Thomas Jefferson University Health System were included. The Brigham and Women’s Hospital served as the central coordinating center. Clinical events were adjudicated by independent physicians. The primary outcome was 90-day major cardiovascular events, defined as venous or arterial thrombosis, myocarditis or heart failure with inpatient treatment, new atrial fibrillation/flutter, or cardiovascular death. Findings were pre-specified to be assessed separately for patients who were hospitalized with COVID-19 vs outpatients.
Results: The study included 9,932 patients (03/2020-06/2022, age: 54.8 ± 19.9 years; 55.7% female). Among hospitalized patients, the 90-day cumulative incidence of primary outcome was 15.4 % (95% CI: (14.2-16.7%). Respective 90-day event rates for outpatients were 2.0% (95% CI: 1.3-15.7%) (Figure, Panel A). Cumulative incidence of 90-day outcomes based on vaccination status (restricted to cohort from 12/14/2020 onward) is summarized in Panel B. The change in cardiovascular events over time is represented in Figure, Panel C.
Conclusions: Adjudicated cardiovascular events are common in hospitalized patients with COVID-19, while the event rates are seven-fold lower among outpatients. Association between vaccination status and outcomes and trends over time require further investigation.