Understanding the Link Between COVID-19 and Heart Attack Risk

Impact of COVID-19 on Heart Attack Risk in Patients with Pre-existing Conditions

Introduction

Research indicates that a positive diagnosis of COVID-19 may elevate the risk of heart attacks in individuals with existing atherosclerotic cardiovascular disease (ASCVD) or familial hypercholesterolemia (FH). While COVID-19 has been linked to increased mortality rates associated with hypertension, heart failure, and cardiovascular disease, the incidence of acute myocardial infarction (AMI) or heart attacks reported during hospital visits has been notably lower throughout the pandemic.

Research Methodology

A collaborative effort among researchers from various institutions across the United States involved the analysis of data from approximately 55 million individuals. The participants were categorized into six distinct groups based on their medical history, including combinations of diagnosed FH, probable FH, diagnosed ASCVD, or none of the aforementioned conditions. To ensure a comprehensive evaluation, the study accounted for variables such as sex, age, ethnicity, education levels, other medical conditions, cholesterol medications, and prior cardiac issues, establishing a baseline for comparison.

Findings on COVID-19 and Heart Attack Risk

The study revealed that individuals who tested positive for COVID-19 exhibited an increased risk of AMI, particularly among those with both diagnosed and probable FH as well as those with pre-existing ASCVD. In contrast, the risk of AMI was lower in COVID-19 positive patients without these conditions.

Limitations of the Study

Despite the extensive data collection, several limitations were noted. The complete medical history for all participants was not available, potentially affecting group classifications due to missing information. Additionally, while various variables were considered to account for baseline differences, factors such as obesity were not included in the analysis.

Exploration of Lipid Lowering Therapies

The researchers also examined any potential correlations between lipid lowering therapies (LLT) and individuals with FH who tested positive for COVID-19. However, no significant relationship was found, as the analyses lacked sufficient statistical power.

Implications of the Findings

These findings may prompt individuals with ASCVD and FH to prioritize receiving a COVID-19 vaccination, given the heightened risk of AMI. Furthermore, the study underscores the critical importance of diagnosing familial hypercholesterolemia, which could lead to improved health outcomes and appropriate treatments for affected individuals.

Source

Myers, K. D., et al. (2021). COVID-19 associated risks of myocardial infarction in persons with familial hypercholesterolemia with or without ASCVD. American Journal of Preventive Cardiology. doi.org/10.1016/j.ajpc.2021.100197.