COVID-19 and heart attack risk

Does a positive COVID-19 diagnosis increase the risk of myocardial infarction for people with pre-existing atherosclerotic cardiovascular disease (ASCVD) or familial hypercholesterolemia (FH)?

It has been shown that higher COVID-19 death rates may be linked to high blood pressure, heart failure, and cardiovascular disease. However, during the pandemic, fewer patients reported acute myocardial infarction (AMI) or heart attacks when visiting hospitals.

Researchers from across the United States collected data from approximately 55 million people for this study. They were categorized into six categories based on the information available, including combinations of diagnosed FH, probable FH, diagnosed ASCVD, and none of the above. Differences between individuals were examined and included variables such as gender, age, ethnicity, and educational level. Other diseases or medical conditions, cholesterol prescriptions, and any history of heart problems were all considered to establish a baseline for the study.

Determination of these factors and their consideration in case of baseline differences between the participants. Those who conducted the study were then able to compare the six groups and more effectively compare who in the groups tested positive for COVID-19 and who did not.

A positive test for COVID-19 was found to have a higher risk of AMI for those with diagnosed and likely FH and for those with pre-existing ASCVD. A higher risk of AMI was also observed compared to other COVID-19 positive patients without ASCVD or FH.

The full medical history was not available to all participants in this study, which led to some notable limitations. Individuals with a history of ASCVD or FH may not have been placed in the correct comparison group due to lack of data.

Although many variables were considered to determine the baseline differences between group members, other factors such as obesity were not considered. The researchers also looked at whether there were correlations between lipid lowering therapies (LLT) and people with FH who tested positive for COVID-19 and not. There was no significant association between people who took LLT and those who did not, as the analyzes were of no statistical significance.

These results may encourage people with ASVD and FH to get a COVID-19 vaccination due to the increased risk of AMI. Additionally, it underscores the importance of diagnosing familial hypercholesterolemia, which could help improve individual health and provide appropriate treatment.

Source:

Myers, K, D., et al. (2021) COVID-19 Associated Risks of Myocardial Infarction in Individuals with Familial Hypercholesterolemia with or without ASCVD. American Journal of Preventive Cardiology. doi.org/10.1016/j.ajpc.2021.100197.

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