Major adverse cardiovascular events (MACE) in patients with severe COVID-19 registered in the ISARIC WHO clinical characterization protocol: A prospective, multinational, observational study.

Autor: Reyes LF; Universidad de La Sabana, Chía, Colombia; Clínica Universidad de La Sabana, Cundinamarca, Colombia; Pandemic Sciences Institute, University of Oxford, Oxford, United Kingdom. Electronic address: luis.reyes5@unisabana.edu.co., Garcia-Gallo E; Universidad de La Sabana, Chía, Colombia; Pandemic Sciences Institute, University of Oxford, Oxford, United Kingdom., Murthy S; Department of Pediatrics, University of British Columbia, Vancouver, Canada., Fuentes YV; Universidad de La Sabana, Chía, Colombia., Serrano CC; Universidad de La Sabana, Chía, Colombia; Clínica Universidad de La Sabana, Cundinamarca, Colombia., Ibáñez-Prada ED; Universidad de La Sabana, Chía, Colombia; Clínica Universidad de La Sabana, Cundinamarca, Colombia., Lee J; Pandemic Sciences Institute, University of Oxford, Oxford, United Kingdom., Rojek A; Pandemic Sciences Institute, University of Oxford, Oxford, United Kingdom., Citarella BW; Pandemic Sciences Institute, University of Oxford, Oxford, United Kingdom., Gonçalves BP; Pandemic Sciences Institute, University of Oxford, Oxford, United Kingdom., Dunning J; Pandemic Sciences Institute, University of Oxford, Oxford, United Kingdom., Rätsep I; Pandemic Sciences Institute, University of Oxford, Oxford, United Kingdom., Viñan-Garces AE; Universidad de La Sabana, Chía, Colombia., Kartsonaki C; Pandemic Sciences Institute, University of Oxford, Oxford, United Kingdom., Rello J; Clinical Research/Epidemiology in Pneumonia & Sepsis (CRIPS), Vall d'Hebron Institute of Research (VHIR), Barcelona, Spain; Centro de Investigación Biomédica En Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain., Martin-Loeches I; Department of Clinical Medicine, St James's Hospital, Multidisciplinary Intensive Care Research Organization (MICRO), Dublin, Ireland., Shankar-Hari M; Centre for Inflammation Research, University of Edinburgh; 47 Little France Crescent, Edinburgh, Scotland, United Kingdom., Olliaro PL; Pandemic Sciences Institute, University of Oxford, Oxford, United Kingdom., Merson L; Pandemic Sciences Institute, University of Oxford, Oxford, United Kingdom.
Jazyk: angličtina
Zdroj: Journal of critical care [J Crit Care] 2023 Oct; Vol. 77, pp. 154318. Date of Electronic Publication: 2023 May 09.
DOI: 10.1016/j.jcrc.2023.154318
Abstrakt: Purpose: To determine its cumulative incidence, identify the risk factors associated with Major Adverse Cardiovascular Events (MACE) development, and its impact clinical outcomes.
Materials and Methods: This multinational, multicentre, prospective cohort study from the ISARIC database. We used bivariate and multivariate logistic regressions to explore the risk factors related to MACE development and determine its impact on 28-day and 90-day mortality.
Results: 49,479 patients were included. Most were male 63.5% (31,441/49,479) and from high-income countries (84.4% [42,774/49,479]); however, >6000 patients were registered in low-and-middle-income countries. MACE cumulative incidence during their hospital stay was 17.8% (8829/49,479). The main risk factors independently associated with the development of MACE were older age, chronic kidney disease or cardiovascular disease, smoking history, and requirement of vasopressors or invasive mechanical ventilation at admission. The overall 28-day and 90-day mortality were higher among patients who developed MACE than those who did not (63.1% [5573/8829] vs. 35.6% [14,487/40,650] p < 0.001; 69.9% [6169/8829] vs. 37.8% [15,372/40,650] p < 0.001, respectively). After adjusting for confounders, MACE remained independently associated with higher 28-day and 90-day mortality (Odds Ratio [95% CI], 1.36 [1.33-1.39];1.47 [1.43-1.50], respectively).
Conclusions: Patients with severe COVID-19 frequently develop MACE, which is independently associated with worse clinical outcomes.
Competing Interests: Declaration of Competing Interest Srinivas Murthy declares receiving salary support from the Health Research Foundation and Innovative Medicines Canada Chair in Pandemic Preparedness Research. Ignacio Martin-Loeches declared lectures for Gilead, Thermofisher, MSD; advisory board participation for Fresenius Kabi, Advanz Pharma, Gilead, Accelerate, and Merck; and consulting fees for Gilead outside of the submitted work. These sponsors have not involvement in this manuscript. All the other authors do not have conflicts of interest to disclose.
(Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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