Patients with peripheral artery disease (PAD) face an above-average risk of death or adverse outcomes when hospitalized for COVID-19, according to a new analysis published in Current Problems in Cardiology.
“COVID-19 is a disease with many diverse manifestations, ranging from asymptomatic disease to mild symptoms, and more severely, thrombotic events, acute respiratory syndrome, and death,” wrote lead author Kim G. Smolderen, PhD, a specialist at Yale University, and colleagues. “As our understanding for the disease evolved, it has become evident that widespread vascular coagulopathy and infection-triggered inflammatory escalations may be mechanisms that explain adverse outcomes such as respiratory failure and mortality.”
Smolderen et al. examined data from nearly 4,000 COVID-19 consecutive adult patients admitted to a single health system from March 2020 to November 2020. The mean patient age was 63.1 years old. While 50.5% of patients were female, 18.3% had PAD.
Mortality (24.5% vs. 12.7%), stroke (5.3% vs. 2.6%) and MI (22.7% vs. 6.7%) were all much more common among patients with PAD than patients without PAD. The overall risk of major adverse cardiovascular events (MACE) was also much higher (44% vs. 19.2%) for this population. After making certain adjustments for patient demographics, PAD was not independently associated with stroke or MI.
In addition, other cardiovascular complications—including a history of atrial fibrillation, chronic heart failure or diabetes—were also more likely to be found in PAD patients.
“Despite most patients with COVID-19 receiving prophylactic heparin while inpatient, they continue to have high rates of thromboembolism,” the authors wrote. “Future studies should look at specific pharmacologic strategies in patients with PAD to reduce the risk of MACE and mortality. Furthermore, understanding the risk profile for COVID-19 associated with PAD will also help us to inform patients with this vulnerability as to what their risks are and to maximize preventive strategies amongst those with the highest risk.”
The team did note that their study had certain limitations. For instance, patient care strategies were constantly evolving as the pandemic continued throughout 2020, something the analysis was not able to accurately reflect. Also, patient medical records were used to track certain conditions; some patients may have had underdiagnosed stroke, MI or even PAD.
The full study is available here.
Michael has more than 16 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.