Contribution of genetics and lifestyle to the risk of major cardiovascular and thromboembolic complications following COVID-19-Reference-Cited by-同舟云学术

Contribution of genetics and lifestyle to the risk of major cardiovascular and thromboembolic complications following COVID-19

Published:2023-01-09 Issue: Volume: Page:
ISSN:
Container-title:
language:
Short-container-title:

Author:

Prieto-Alhambra Daniel¹^ORCID,Xie Junqing²^ORCID,Feng Yuliang³,Newby Danielle²,Zheng Bang⁴,Feng Qi⁵,Prats-Uribe Albert⁶^ORCID,Li Chunxiao⁷,Wareham Nick⁸^ORCID,Paredes Roger⁹

Affiliation:

1. 1. Centre for Statistics in Medicine (CSM), Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences 2.Department of Medical Informatics, Erasmus University, Rotterdam

2. Centre for Statistics in Medicine and NIHR Biomedical Research Centre Oxford, NDORMS, University of Oxford

3. University of Oxford

4. London School of Hygiene and Tropical Medicine

5. Nuffield Department of Population Health, University of Oxford

6. Centre for Statistics in Medicine , University of Oxford

7. Medical Research Council Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, University of Cambridge

8. MRC Epidemiology Unit

9. Infectious Diseases Department & irsiCaixa AIDS Research Institute, Hospital Universitari Germans 13 Trias i Pujol

Abstract

Abstract Clinical determinants for cardiovascular and thromboembolic (CVE) complications of COVID-19 are well-understood, but the roles of genetics and lifestyle remain unknown. We performed a prospective cohort study using UK Biobank, including 25,335 participants with confirmed SARS-CoV-2 infection between March 1, 2020, and September 3, 2021. Outcomes were hospital-diagnosed atrial fibrillation (AF), coronary artery disease (CAD), ischemic stroke (ISS), and venous thromboembolism (VTE) within 90 days post-infection. Heritable risk was represented by validated polygenic risk scores (PRSs). Lifestyle was defined by a composite of nine variables. We estimated adjusted hazard ratios (aHR) and confidence intervals (CI) using Cox proportional hazards models. In the COVID-19 acute phase, PRSs linearly predicted a higher risk of AF (aHR 1.52 per standard deviation increase, 95% CI 1.39 to 1.67), CAD (1.59, 1.40 to 1.81), and VTE (1.30, 1.11 to 1.53), but not ISS (0.92, 0.64 to 1.33). A healthy lifestyle was associated with a substantially lower risk of post-COVID-19 AF (0.70, 0.53 to 0.92), CAD (0.64, 0.44 to 0.91), and ISS (0.28, 0.12 to0.64), but not VTE (0.82, 0.48 to 1.39), compared with an unhealthy lifestyle. No evidence for interactions between genetics and lifestyle was found. Our results demonstrated that population genetics and lifestyle considerably influence cardiovascular complications following COVID-19, with implications for future personalised thromboprophylaxis and healthy lifestyle campaigns to offset the elevated cardiovascular disease burden imposed by the ongoing pandemic.

Publisher

Research Square Platform LLC

Reference45 articles.

1. Cardiovascular diseases (CVDs). https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds). Updated August 10, 2022. Accessed August 17, 2022.

2. Farshidfar F, Koleini N, Ardehali H. Cardiovascular complications of COVID-19. JCI Insight. 2021;6(13). doi:10.1172/jci.insight.148980.

3. Guzik TJ, Mohiddin SA, Dimarco A, et al. COVID-19 and the cardiovascular system: implications for risk assessment, diagnosis, and treatment options. Cardiovasc Res. 2020;116(10):1666–1687. doi:10.1093/cvr/cvaa106.

4. Understanding the burden of CVD. Facts and figures. https://www.escardio.org/The-ESC/Advocacy/understanding-the-burden-of-cvd-facts-and-figures. Updated August 17, 2022. Accessed August 17, 2022.

5. Antithrombotic Therapy | COVID-19 Treatment Guidelines. https://www.covid19treatmentguidelines.nih.gov/therapies/antithrombotic-therapy/?utm_medium=email&utm_source=transaction. Updated March 2, 2022. Accessed March 5, 2022.