Covid-19 may increase heart attack risk long after recovery, says study

In a new study, doctors have warned that the inflammation triggered by Covid-19 virus can continue to affect the cardiovascular health long after the recovery, raising risk of heart attack and even death.

The research published in Radiology, the journal of the Radiological Society of North America (RSNA), notes that Covid is linked to accelerated plaque buildup in the coronary arteries, increasing the risk of heart-related complications.

“COVID-19, caused by SARS-CoV-2, is initially characterized by acute lung injury and respiratory failure,” explained the study’s senior author, Junbo Ge, M.D., professor and director of the Cardiology Department at Zhongshan Hospital, Fudan University in Shanghai, China. “However, emerging evidence indicates COVID-19 also involves an extreme inflammatory response that can affect the cardiovascular system.”

How the study was carried out

Researchers for the study examined changes in the tissue surrounding the coronary arteries using coronary CT angiography (CCTA). Signs of inflammation, plaque buildup, and the presence of high-risk arterial blockages were examined.

The study looked at 803 patients who underwent CCTA between September 2018 and October 2023, with an average age of 63.9 years, including 543 men. Of these, 329 patients were imaged before the COVID-19 pandemic, and 474 during it, with 25 having had a prior SARS-CoV-2 infection. The research team analyzed 2,588 coronary artery lesions—2,108 from infected patients and 480 from uninfected ones. They compared plaque volume changes, the presence of high-risk plaque, inflammation, and cardiovascular events like heart attacks or revascularization procedures.

How the virus increased risk of heart attack

At the start, the average artery narrowing (stenosis) per lesion was 31.3%, with only 8.1% of lesions showing 50% or more narrowing. In patients with SARS-CoV-2, plaque volumes increased more quickly than in uninfected patients. These lesions also had a higher chance of becoming high-risk plaques (20.1% vs. 15.8%) and showed more coronary inflammation (27% vs. 19.9%). Additionally, COVID-19 patients had a higher risk of target lesion failure (10.4% vs. 3.1%), which signals an increased risk of heart attack or stroke.

“Inflammation following COVID-19 can lead to ongoing plaque growth, particularly in high-risk, noncalcified plaques.” Dr. Ge said. “Patients with SARS-CoV-2 infection are at increased risk for myocardial infarction, acute coronary syndrome, and stroke for up to a year.”

He added that these effects persist long after the infection, regardless of comorbidities such as age, hypertension, and diabetes.

“Effective management strategies for these patients are imperative,” Dr. Ge said.

“It’s crucial to anticipate a heavier cardiovascular patient burden in the future as most infected individuals recover from acute SARS-CoV-2 infection,” Dr. Ge said.