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Meta-Analysis
. 2023 Feb 1:372:138-143.
doi: 10.1016/j.ijcard.2022.12.032. Epub 2022 Dec 16.

Increased risk of acute myocardial infarction after COVID-19 recovery: A systematic review and meta-analysis

Marco Zuin  1 , Gianluca Rigatelli  2 , Valentina Battisti  3 , Giulia Costola  3 , Loris Roncon  4 , Claudio Bilato  3
Affiliations
Meta-Analysis

Increased risk of acute myocardial infarction after COVID-19 recovery: A systematic review and meta-analysis

Marco Zuin et al. Int J Cardiol. .

Abstract

Background: Few studies have analyzed the incidence and the risk of acute myocardial infarction (AMI) during the post-acute phase of COVID-19 infection.

Objective: To assess the incidence and risk of AMI in COVID-19 survivors after SARS-CoV-2 infection by a systematic review and meta-analysis of the available data.

Methods: Data were obtained searching MEDLINE and Scopus for all studies published at any time up to September 1, 2022 and reporting the risk of incident AMI in patients recovered from COVID-19 infection. AMI risk was evaluated using the Mantel-Haenszel random effects models with Hazard ratio (HR) as the effect measure with 95% confidence interval (CI) while heterogeneity was assessed using Higgins and Thomson I2 statistic.

Results: Among 2765 articles obtained by our search strategy, four studies fulfilled the inclusion criteria for a total of 20,875,843 patients (mean age 56.1 years, 59.1% males). Of them, 1,244,604 had COVID-19 infection. Over a mean follow-up of 8.5 months, among COVID-19 recovered patients AMI occurred in 3.5 cases per 1.000 individuals compared to 2.02 cases per 1.000 individuals in the control cohort, defined as those who did not experience COVID-19 infection in the same period). COVID-19 patients showed an increased risk of incident AMI (HR: 1.93, 95% CI: 1.65-2.26, p < 0.0001, I2 = 83.5%). Meta-regression analysis demonstrated that the risk of AMI was directly associated with age (p = 0.01) and male gender (p = 0.001), while an indirect relationship was observed when the length of follow-up was utilized as moderator (p < 0.001).

Conclusion: COVID-19 recovered patients had an increased risk of AMI.

Keywords: Acute myocardial infarction; COVID-19; Long-Covid; Sequelae.

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Conflict of interest statement

Declaration of Competing Interest None of the authors have conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
PRISMA flowchart. * Articles excluded because not provided data on acute myocardial infarction events; ** Articles excluded because not provided Hazard ratio for acute myocardial infarction.
Fig. 2
Fig. 2
(A) Forest plots investigating the pooled incidence of acute myocardial infarction after 8.5 months from COVID-19 infection. (B) Forest plots investigating the risk of acute myocardial infarction after 8.5 months from COVID-19 infection.
See this image and copyright information in PMC

Comment in

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