• Velásquez GarcíaHéctor AlexanderHAData and Analytic Services, British Columbia Centre for Disease Control, Vancouver, British Columbia V5Z 4R4, Canada; School of Population and Public Health, University of British Columbia, Vancouver, British Columbia V6T, Stanley Wong, Dahn Jeong, Mawuena Binka, Zaeema Naveed, James Wilton, Nathaniel Mark Hawkins, and Naveed Zafar Janjua.
• Data and Analytic Services, British Columbia Centre for Disease Control, Vancouver, British Columbia V5Z 4R4, Canada; School of Population and Public Health, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada.
• Am. J. Med. 2024 Apr 24.

BackgroundCOVID-19 is associated with increased risk of post-acute cardiovascular outcomes. Population-based evidence for long periods of observation is still limited.MethodsThis 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.ResultsWe 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.ConclusionsSARS-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.Copyright © 2024. Published by Elsevier Inc.

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