Hypertension Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
BMC Cardiovasc Disord. 2023 May 6;23(1):241. doi: 10.1186/s12872-023-03256-1.
Coronary artery disease (CAD) is considered an independent risk factor for COVID-19. However, no study has specifically examined the clinical manifestations and outcomes of COVID-19 in patients with ischemic heart disease (IHD).
In a retrospective case-control study between 20 March 2020 to 20 May 2020, the medical record of 1611 patients with laboratory-confirmed SARS-CoV-2 infection was reviewed. IHD was defined as a history of an abnormal coronary angiography, coronary angioplasty, coronary artery bypass graft (CABG), or chronic stable angina. Demographic data, past medical history, drug history, symptoms, vital signs, laboratory findings, outcome, and death were investigated from medical records.
1518 Patients (882 men (58.1%)) with a mean age of 59.3 ± 15.5 years were included in the study. Patients with IHD (n = 300) were significantly less likely to have fever (OR: 0.170, 95% CI: 0.34-0.81, P < 0.001), and chills (OR: 0.74, 95% CI: 0.45-0.91, P < 0.001). Patients with IHD were 1.57 times more likely to have hypoxia (83.3% vs. 76%, OR: 1.57, 95% CI: 1.13-2.19, P = 0.007). There was no significant difference in terms of WBC, platelets, lymphocytes, LDH, AST, ALT, and CRP between the two groups (P > 0.05). After adjusting for demographic characteristics, comorbidities and vital signs, the risk factors for mortality of these patients were older age (OR: 1.04 and 1.07) and cancer (OR: 1.03, and 1.11) in both groups. In addition, in the patients without IHD, diabetes mellitus (OR: 1.50), CKD (OR: 1.21) and chronic respiratory diseases (OR: 1.48) have increased the odds of mortality. In addition, the use of anticoagulants (OR: 2.77) and calcium channel blockers (OR: 2.00) has increased the odds of mortality in two groups.
In comparison with non-IHD, the symptoms of SARS-CoV-2 infection such as fever, chills and diarrhea were less common among patients with a history of IHD. Also, older age, and comorbidities (including cancer, diabetes mellitus, CKD and chronic obstructive respiratory diseases) have been associated with a higher risk of mortality in patients with IHD. In addition, the use of anticoagulants and calcium channel blockers has increased the chance of death in two groups without and with IHD.
冠心病（CAD）被认为是 COVID-19 的独立危险因素。然而，尚无研究专门探讨缺血性心脏病（IHD）患者 COVID-19 的临床表现和结局。
在 2020 年 3 月 20 日至 2020 年 5 月 20 日期间进行的一项回顾性病例对照研究中，对 1611 例实验室确诊的 SARS-CoV-2 感染患者的病历进行了回顾。IHD 的定义为异常冠状动脉造影、经皮冠状动脉介入治疗、冠状动脉旁路移植术（CABG）或慢性稳定性心绞痛的病史。从病历中调查了人口统计学数据、既往病史、用药史、症状、生命体征、实验室检查结果、结局和死亡情况。
研究纳入了 1518 例患者（882 例男性（58.1%）），平均年龄为 59.3±15.5 岁。有 IHD 病史的患者（n=300）出现发热（比值比[OR]：0.170，95%置信区间[CI]：0.34-0.81，P<0.001）和寒战（OR：0.74，95% CI：0.45-0.91，P<0.001）的可能性明显较低。与无 IHD 的患者相比，有 IHD 的患者发生缺氧的可能性高 1.57 倍（83.3%比 76%，OR：1.57，95% CI：1.13-2.19，P=0.007）。两组间白细胞计数、血小板计数、淋巴细胞计数、乳酸脱氢酶、天冬氨酸氨基转移酶、丙氨酸氨基转移酶和 C 反应蛋白无显著差异（P>0.05）。在调整了人口统计学特征、合并症和生命体征后，两组患者死亡的危险因素为年龄较大（OR：1.04 和 1.07）和癌症（OR：1.03 和 1.11）。此外，在无 IHD 的患者中，糖尿病（OR：1.50）、慢性肾脏病（OR：1.21）和慢性呼吸系统疾病（OR：1.48）增加了死亡的可能性。此外，抗凝剂（OR：2.77）和钙通道阻滞剂（OR：2.00）的使用增加了两组患者的死亡几率。
与非 IHD 患者相比，有 IHD 病史的患者 COVID-19 感染的症状（如发热、寒战和腹泻）较少见。此外，年龄较大和合并症（包括癌症、糖尿病、慢性肾脏病和慢性阻塞性呼吸系统疾病）与 IHD 患者的死亡率较高相关。此外，抗凝剂和钙通道阻滞剂的使用增加了两组患者（有和无 IHD）的死亡几率。
