| アブストラクト | 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. |
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| ジャーナル名 | European heart journal open |
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| 投稿日 | 2023/12/4 |
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| 投稿者 | la Roi-Teeuw, Hannah M; van Smeden, Maarten; Geersing, Geert-Jan; Klungel, Olaf H; Rutten, Frans H; Souverein, Patrick C; van Doorn, Sander |
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| 組織名 | Department of General Practice and Nursing Science, Julius Center for Health;Sciences and Primary Care, University Medical Center Utrecht, Universiteitsweg;100, 3584 CX, Utrecht, The Netherlands.;Department of Epidemiology and Health Economics, Julius Center for Health;Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The;Netherlands.;Department of Data Science and Biostatistics, Julius Center for Health Sciences;and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.;Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for;Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/38046622/ |
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