Increased mortality in myocardial infarction after COVID-19 infection: more and more convincing data
Clicks: 3
ID: 317317
2026
Article Quality & Performance Metrics
Overall Quality
Not rated
Combines reader engagement with the AI quality analysis. This
article has not been analysed, so there is no overall score —
reader engagement is measured and shown alongside.
Reader Engagement
Emerging Content
0.6
/100
3 views
2 readers
AI Quality Assessment
Not analyzed
Readership in this journal
EmergingRanked #151 of 196 articles by views in european journal of preventive cardiology
Most read
Least read
Bar heights use a square-root scale. Only the 120 most-read articles are drawn; the journal has 196 in total.
Mint this article as an NFT
Not yet mintedCreate a permanent, verifiable on-chain record of this article on the Scimatic Network. The NFT is held in your Journament account, and you can withdraw it to your own wallet at any time.
5
SUSD
one-off · no wallet required
Abstract
This editorial refers to ‘Recent COVID-19 and mortality after myocardial infarction: a Danish nationwide cohort study’, by K.D. Brodersen et al. https://doi.org/10.1093/eurjpc/zwaf538. Drodersen et al.1 are to be congratulated for conducting a convincing and impressive population-based cohort study based on Danish health registry data. They included in excess of 12,000 individuals with first-time myocardial infarction (MI) during the acute and initial phase of the COVID-19 pandemic (26 May 2020 to 9 March 2022), of whom 337 (2.8%) had recent COVID-19 infection. Compared to MI patients without a recent COVID-19 infection, those with the infection yielded an adjusted hazard ratio (HR) of 1.64 (95% confidence interval [CI] 1.16–2.31) for 30-day death and 1.28 (0.92–1.78) for 180-day death. An increased risk of death after MI associated with recent COVID-19 infection was observed only in patients who had not been vaccinated against COVID-19, with adjusted HRs of 2.88 (95% CI 1.78–4.64) for 30-day mortality and 2.09 (95% CI 1.30–3.36) for 180-day mortality. In contrast, vaccinated patients showed no significant increase in risk (HR 1.11, 95% CI 0.65–1.90; and HR 0.97, 95% CI 0.60–1.56, respectively). Furthermore, among unvaccinated individuals, both 30-day death and 180-day mortality after MI were higher for those with recent versus past (>90 days) COVID-19 infection, suggesting a protective effect of vaccination. The authors have appropriately acknowledged several limitations of their study: lack of data on revascularization procedures and treatment delays, incomplete documentation of risk factors (notably the absence of smoking status), lack of information on COVID-19 infection status, and heterogeneity of the study sample due to the preponderance of the Omicron variant. They have also outlined the study’s strengths, including propensity scoring and multiple sensitivity analyses to account for confounders, stratification by previous vaccination status, and consideration of the SARS CoV-2 variant. In addition, the death rate was analysed across three time intervals: 0–14 days, 15–30 days, and 31–180 days after admission for MI, allowing for a more nuanced assessment of the effect of acute SARS-CoV-2 infection and associated comorbidities. In the literature, a meta-analysis of studies comparing rates of in-hospital death between COVID-19-positive and COVID-19-negative cohorts with ST-segment elevation MI identified a higher rate of in-hospital death among the COVID-19-positive patients (odds ratio 4.07, 95% CI 2.48–6.69), due at least in part to a prolonged door-to-balloon time.2 A nationwide observational study of all patients hospitalized for MI in France from 30 December 2019 to 4 October 2020 reported an in-hospital mortality rate of 8.1% and a 90-day post-discharge mortality rate of 4.0% in patients with previous COVID-19, compared with 3.5% and 3.0%, respectively, in patients without concomitant or previously confirmed COVID-19 infection. Both in-hospital and 90-day post-discharge mortality rates were increased in patients with previous COVID-19 (adjusted odds ratio 3.31, 95% CI 2.32–4.72, and 2.09, 1.24–3.51, respectively). The in-hospital mortality rate for patients with previous COVID-19 infection was also increased (adjusted odds ratio 1.83, 0.97–3.46).3 A retrospective, nationwide, observational cohort study based on the French administrative hospital-discharge database included 288 408 patients hospitalized for acute MI from March 2020 to January 2023.4 Among these patients, 26 879 had a COVID-19-positive test result between 15 days before to 5 days after admission. The primary outcomes were the incidences of all-cause death, cardiovascular death, heart failure, recurrence of acute MI, ischaemic stroke, incident atrial fibrillation, ventricular tachycardia/ventricular fibrillation, and cardiac arrest. After propensity-scoring, patients with acute MI and COVID-19 infection were matched to those without COVID-19. Patients with COVID-19 had higher risks of all-cause death (HR 1.255, 95% CI 1.203–1.308; P < 0.0001), heart failure (HR 1.205, 95% CI 1.159–1.254; P < 0.0001), ischaemic stroke (HR 1.237, 95% CI 1.084–1.411; P = 0.002), incident atrial fibrillation (HR 1.160, 95% CI 1.070–1.258; P = 0.0003), and ventricular tachycardia/ventricular fibrillation (HR 1.360, 95% CI 1.200–1.540; P < 0.0001). The risk of cardiovascular death was lower in patients with COVID-19 (HR 0.932, 95% CI 0.879–0.988; P = 0.02) because of competition with non-cardiovascular death. Many hypotheses can be put forward to explain the increase in all-cause death in patients with acute MI infected by SARS-CoV-2. Firstly, we know that fewer patients were hospitalized for acute MI and treated during the first lockdown compared with previous years.5 The median time from symptom onset to reperfusion and intra-hospital death also increased.6 Delayed reperfusion may be attributed to saturation of emergency healthcare services, the implementation of COVID-19 protective measures for all caregivers, and changes in patient behaviour.7 In addition, vaccination against SARS-CoV-2 protect from myocardial infarction, stroke, and veinous thromboembolic events and their complications.8 In brief, unvaccinated patients with MI and recent COVID-19 infection experienced higher incidences of 30-day and 180-day mortality than unvaccinated patients with MI and no recent COVID-19 infection.1,9,10 Further analyses are needed to confirm these findings and elaborate on the exact mechanisms involved, the logistical constraints, and interactions between the haemostatic/inflammatory profile and the natural history of cardiovascular complications.11,12 Ariel Cohen (MD PhD (Conceptualization [lead]; Writing—original draft [lead])), Frank Boccara (Conceptualization [lead]; Writing—original draft [lead]), and Laurie Soulat-Dufour (Conceptualization [lead]; Writing—original draft [lead])
| Reference Key |
openalex_W7164862632
Use this key to autocite in the manuscript while using
SciMatic Manuscript Manager or Thesis Manager
|
|---|---|
| Authors | Franck Boccara, Laurie Soulat-Dufour, Ariel Cohen |
| Journal | european journal of preventive cardiology |
| Year | 2026 |
| DOI |
10.1093/eurjpc/zwaf702
|
| URL | |
| Keywords | Keywords not found |
Citations
No citations found. To add a citation, contact the admin at info@scimatic.org
Comments
No comments yet. Be the first to comment on this article.