| Title: | COVID-19 Is a Coronary Artery Disease Risk Equivalent and Exhibits a Genetic Interaction With ABO Blood Type |
| Journal: | Arteriosclerosis Thrombosis and Vascular Biology |
| Published: | 9 Oct 2024 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/39381876/ |
| DOI: | https://doi.org/10.1161/atvbaha.124.321001 |
Publication 13259
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Abstract
BACKGROUND: COVID-19 is associated with acute risk of major adverse cardiac events (MACE), including myocardial infarction, stroke, and mortality (all-cause). However, the duration and underlying determinants of heightened risk of cardiovascular disease and MACE post-COVID-19 are not known.</p>
METHODS: Data from the UK Biobank was used to identify COVID-19 cases (n=10 005) who were positive for polymerase chain reaction (PCR+)-based tests for SARS-CoV-2 infection (n=8062) or received hospital-based International Classification of Diseases version-10 (ICD-10) codes for COVID-19 (n=1943) between February 1, 2020 and December 31, 2020. Population controls (n=217 730) and propensity score-matched controls (n=38 860) were also drawn from the UK Biobank during the same period. Proportional hazard models were used to evaluate COVID-19 for association with long-term (>1000 days) risk of MACE and as a coronary artery disease risk equivalent. Additional analyses examined whether COVID-19 interacted with genetic determinants to affect the risk of MACE and its components.</p>
RESULTS: The risk of MACE was elevated in COVID-19 cases at all levels of severity (HR, 2.09 [95% CI, 1.94-2.25]; P<0.0005) and to a greater extent in cases hospitalized for COVID-19 (HR, 3.85 [95% CI, 3.51-4.24]; P<0.0005). Hospitalization for COVID-19 represented a coronary artery disease risk equivalent since incident MACE risk among cases without history of cardiovascular disease was even higher than that observed in patients with cardiovascular disease without COVID-19 (HR, 1.21 [95% CI, 1.08-1.37]; P<0.005). A significant genetic interaction was observed between the ABO locus and hospitalization for COVID-19 (Pinteraction=0.01), with risk of thrombotic events being increased in subjects with non-O blood types (HR, 1.65 [95% CI, 1.29-2.09]; P=4.8×10-5) to a greater extent than subjects with blood type O (HR, 0.96 [95% CI, 0.66-1.39]; P=0.82).</p>
CONCLUSIONS: Hospitalization for COVID-19 represents a coronary artery disease risk equivalent, with post-acute myocardial infarction and stroke risk particularly heightened in non-O blood types. These results may have important clinical implications and represent, to our knowledge, one of the first examples of a gene-pathogen exposure interaction for thrombotic events.</p>
17 Keywords
- ABO Blood-Group System
- Adult
- Aged
- COVID-19
- Case-Control Studies
- Coronary Artery Disease
- Female
- Galactosyltransferases
- Genetic Predisposition to Disease
- Humans
- Male
- Middle Aged
- Risk Assessment
- Risk Factors
- SARS-CoV-2
- Time Factors
- United Kingdom
11 Authors
- James R. Hilser
- Neal J. Spencer
- Kimia Afshari
- Frank D. Gilliland
- Howard Hu
- Arjun Deb
- Aldons J. Lusis
- W.H. Wilson Tang
- Jaana A. Hartiala
- Stanley L. Hazen
- Hooman Allayee
1 Application
| Application ID | Title |
|---|---|
| 33307 | Sex-specific Genetic Determinants of Cardiometabolic Traits |
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