Medical College of Wisconsin
CTSICores SearchResearch InformaticsREDCap

Major adverse cardiovascular events (MACE) in patients with severe COVID-19 registered in the ISARIC WHO clinical characterization protocol: A prospective, multinational, observational study. J Crit Care 2023 Oct;77:154318

Date

05/12/2023

Pubmed ID

37167775

Pubmed Central ID

PMC10167415

DOI

10.1016/j.jcrc.2023.154318

Scopus ID

2-s2.0-85158882967 (requires institutional sign-in at Scopus site)   6 Citations

Abstract

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.

Author List

Reyes LF, Garcia-Gallo E, Murthy S, Fuentes YV, Serrano CC, Ibáñez-Prada ED, Lee J, Rojek A, Citarella BW, Gonçalves BP, Dunning J, Rätsep I, Viñan-Garces AE, Kartsonaki C, Rello J, Martin-Loeches I, Shankar-Hari M, Olliaro PL, Merson L, ISARIC Characterisation Group

Author

Lucian A. Durham MD, PhD Associate Professor in the Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Cardiovascular Diseases
Female
Humans
Male
Prospective Studies
Risk Factors
World Health Organization