| Title: |
Incidence and individual risk prediction of post-COVID-19 cardiovascular disease in the general population: a multivariable prediction model development and validation study. |
| Authors: |
la Roi-Teeuw, Hannah M, van Smeden, Maarten, Geersing, Geert-Jan, Klungel, Olaf H, Rutten, Frans H, Souverein, Patrick C, van Doorn, Sander |
| Source: |
European Heart Journal Open; Nov2023, Vol. 3 Issue 6, p1-12, 12p |
| Subject Terms: |
HEART failure, CARDIOVASCULAR diseases, COVID-19 pandemic, COVID-19, PREDICTION models, ATRIAL fibrillation |
| Geographic Terms: |
UNITED Kingdom |
| Abstract: |
Aims: Previous studies suggest relatively increased cardiovascular risk after COVID-19 infection. This study assessed incidence and explored individual risk and timing of cardiovascular disease occurring post-COVID-19 in a large primary care database. Methods and results: Data were extracted from the UK's Clinical Practice Research Datalink. Incidence rates within 180 days post-infection were estimated for arterial or venous events, inflammatory heart disease, and new-onset atrial fibrillation or heart failure. Next, multivariable logistic regression models were developed on 220 751 adults with COVID-19 infection before 1 December 2020 using age, sex and traditional cardiovascular risk factors. All models were externally validated in (i) 138 034 vaccinated and (ii) 503 404 unvaccinated adults with a first COVID-19 infection after 1 December 2020. Discriminative performance and calibration were evaluated with internal and external validation. Increased incidence rates were observed up to 60 days after COVID-19 infection for venous and arterial cardiovascular events and new-onset atrial fibrillation, but not for inflammatory heart disease or heart failure, with the highest rate for venous events (13 per 1000 person-years). The best prediction models had c-statistics of 0.90 or higher. However, <5% of adults had a predicted 180-day outcome-specific risk larger than 1%. These rare outcomes complicated calibration. Conclusion: Risks of arterial and venous cardiovascular events and new-onset atrial fibrillation are increased within the first 60 days after COVID-19 infection in the general population. Models' c-statistics suggest high discrimination, but because of the very low absolute risks, they are insufficient to inform individual risk management. Graphical Abstract Abbreviations: py, person-years; AMI, acute myocardial infarction; VTE, venous thrombo-embolic events; AF, new-onset atrial fibrillation; HF, new-onset heart failure [ABSTRACT FROM AUTHOR] |
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| Database: |
Complementary Index |
