long-term major adverse cardiovascular events in patients with moderate and severe covid-19: focused on early statin use and previous cvd

Background: limited data exist regarding the status of long-term cardiovascular disease (cvd) outcomes of hospitalized covid-19 patients. we aimed to examine the efficacy of early statin use after sars‑cov‑2 pneumonia and the impact of prior cvd on the incidence of cardiovascular events.methods: a prospective cohort study was performed on hospitalized covid-19 patients. the primary endpoint was major adverse cardiovascular events (mace) as a composite of cardiovascular mortality, stroke, heart failure, venous thromboembolism (vte), revascularization, and nonfatal myocardial infarction (mi). the secondary endpoints comprised mace components, all-cause mortality, readmission for covid-19, and impaired functional classes.results: the mean age of the 858 participants was 55.52±13.97 years, and the median follow-up time was 13 months (11.5-15). men comprised 63.9% of the patients. overall, mace occurred in 84 subjects (9.8%), and 98 patients (11.4%) received ventilation. a multivariate cox regression model was employed to explore the association between statin use and outcomes, and the following hazard ratios were obtained: mace (0.831 [0.529 to 0.981]; p=0.044), all-cause mortality (1.098 [0.935 to 1.294]; p=0.255), stroke (0.118 [0.029 to 0.48]; p=0.003), revascularization (0.103 [0.029 to 0.367]; p<0.0001), poor functional capacity (0.827 [0.673 to 1.018]; p=0.073), nonfatal mi (0.599 [0.257 to 1.394]; p=0.234), vte (0.376 [0.119 to 1.190]; p=0.096), and decompensated heart failure (0.137 [0.040 to 0.472]; p=0.002). prior cvd predicted mace (2.953 [1.393 to 6.271]; p=0.005), all-cause death (1.170 [0.960 to 1.412]; p=0.102), and vte (2.770 [0.957 to 8.955]; p=0.051).conclusion: previous cvd is a robust predictor of long-term mace and vte. early statin use might decrease the incidence rates of mace, ischemic stroke, revascularization, and readmission for heart failure.