COVID-19 may increase heart attack and stroke risk for years

People infected with the COVID-19 virus in 2020 may have double the risk for future 心脏病发作, 三年后中风或任何原因导致的过早死亡——即使他们从未表现出严重疾病的迹象, 根据一项新的研究. 在大流行的第一年，因COVID-19住院的人的风险可能要高得多.

研究结果表明，2020年因COVID-19住院与“冠状动脉疾病风险相当”,“这增加了未来心脏病发作的风险, 没有心血管疾病史的人中风或死亡的风险高于没有COVID病史的人. The continued increased risk was especially pronounced in people with non-O blood types, 正如该研究的作者所说，这是基因和病原体之间相互作用增加人类心脏病发作和中风风险的第一个例子之一.

The analysis, which did not include people infected after vaccines were widely available, was 周三发布的 in the 美国心脏协会 journal Arteriosclerosis, Thrombosis, and Vascular Biology.

“从一开始, we knew there was an increased risk of cardiovascular events, but we thought it might be just during the acute phase of infection,该研究的资深作者之一说, Dr. Hooman Allayee, 洛杉矶南加州大学凯克医学院人口和公共卫生科学教授. “我们的研究显示三年后, 在第一波感染期间感染COVID的人患心脏病的风险持续增加, 中风和死亡.

"COVID, despite the vaccines, is still a public health issue,他说. "Not only does COVID infect the lungs and cause long COVID, 这东西喜欢血管系统."

Allayee说，新的研究发现，“即使是那些刚刚检测呈阳性但不一定会出现严重症状的人, 患心血管疾病的风险是前者的两倍. It appears to do damage that is long-lasting in some individuals, and that's what we are seeing."

之前的研究表明，在因COVID-19入院的患者中，多达25%的人心血管系统可能会受到影响, 导致心脏病发作, 心律失常, 心脏衰竭, 心脏骤停或中风.

研究还发现，血型可能在COVID-19易感性和患心血管疾病的风险中发挥作用. 先前的研究发现，O型血的人感染导致COVID-19的病毒的风险低于其他血型的人, and that people with type A or B have a higher risk for heart disease, 心脏病发作, 与O型血的同龄人相比.

在新的研究中, 研究人员分析了英国生物银行的数据，这是世界上最大、最全面的健康数据来源之一,005 people who tested positive for the coronavirus or were hospitalized in the U.K. 2019冠状病毒病. 1日和12月. 31, 2020. 研究人员想知道这种疾病——在严重程度的任何阶段——是否与主要心血管线上娱乐电子游戏网站的长期风险增加有关，以及血型是否起了作用.

他们追踪了心脏病发作的发展情况, 中风和任何原因导致的死亡超过1年,000天, 或者大约三年, 感染后.

不管疾病的严重程度如何, 在研究过程中，感染病毒的参与者患主要心血管疾病的风险是未感染病毒的人的两倍. 与COVID-19检测呈阴性的人相比，因COVID-19住院的人发生重大心血管线上娱乐电子游戏网站的持续风险增加了近四倍.

心脏病发作和中风风险的增加似乎是与ABO基因位点（决定血型的基因）相互作用的结果，在A型血患者身上表现得更为明显, B型和AB型血的人与O型血的人相比, who did not exhibit increased risk for 心脏病发作 or strokes. 全球约60%的人口是非o型血.

该研究还表明，没有心血管疾病史的COVID-19住院患者的患病几率是健康人的7倍, COVID-negative peers to experience major cardiovascular events within three years. 如果住院病人有心血管疾病, they were 12 times more likely to experience a subsequent heart attack, 中风或死亡.

而Allayee和他的同事并没有研究COVID-19如何增加心血管线上娱乐电子游戏网站的风险, 先前的研究揭示了一些潜在的机制, 他说.

2023年的一项研究 自然-心血管研究 found evidence of the virus in the artery walls of people who died of COVID-19. 该病毒还引发了炎症反应, releasing molecules known to contribute to 心脏病发作 and strokes. 研究结果表明，这种病毒通过感染动脉壁并进入现有的斑块，增加了心脏病发作和中风的风险, Allayee说.

“病毒会感染心脏本身, 但它也会渗透到动脉壁的细胞和在那里形成的斑块内的细胞,他说. "If we are seeing an increased risk of heart disease and stroke three years later, 这种浸润可能以某种方式破坏斑块的稳定，对动脉壁造成损害，使斑块更容易破裂."

Because the new findings stem from an observational and not a randomized study, researchers can't say for certain that COVID-19 infections are causing the higher risk, 博士说. Sandeep Das, 他是达拉斯德州大学西南医学中心内科心脏病学部的医学教授.

"What we can say is that there's an association," said Das, who was not involved in the new study. "But we can't exactly randomize people to have COVID-19 to know for sure."

然而, 血型之间的联系, COVID-19感染和未来心血管线上娱乐电子游戏网站风险为COVID-19可能增加心脏病发作或中风几率的理论提供了证据, 他说. “那, 至少是间接的, argues there's some biology involved in creating a higher vulnerability. Observational data don't prove causality, but they certainly don't disprove it either."

这项研究为研究人员了解COVID-19患者随着线上电子游戏飞禽走兽的推移会发生什么做出了重要贡献, 达斯说.

"When COVID first appeared, we were really worried about its acute cardiac effects,他说. “随着我们对这种感染的管理越来越好, we're becoming more concerned about the long-term cardiovascular complications. 但是没有大量的数据."

新发现提出了是否以及如何治疗COVID-19患者以预防未来心血管线上娱乐电子游戏网站的问题, Allayee说.

“如果这在未来的研究中被复制, cardiologists need to start thinking about what to do for these people,他说. "Diabetes is also a coronary artery disease risk equivalent. If we treat people who have diabetes with medication to prevent heart disease, should we do the same for people who were hospitalized for COVID-19?"

该研究的亚分析结果指出了一种可能被考虑的预防措施, Allayee说. Among people hospitalized for COVID-19 with no history of cardiovascular disease, 服用抗血小板药物的患者, 比如阿司匹林, faced a slightly lower risk for 心脏病发作 and strokes than those who didn't.

“我们需要开始用阿司匹林治疗这些人吗?他问.

每日服用阿司匹林, 即使剂量很低, 可能并不适合所有人, especially if there's no history of heart attack or stroke, 根据 2019年的指导方针 from the AHA and American College of Cardiology for preventing cardiovascular disease. People should consult with their primary care physician before taking low-dose aspirin.

然而, there are many preventive measures people can and should take to prevent 心脏病发作 and strokes, 无论他们是否感染了COVID-19, 达斯说.

And for those who have, "you can't go back and not have COVID,他说. “你要意识到，根据你的风险因素，你的风险可能比你想象的要高. 检查你可以修改的内容. 戒烟，运动，健康饮食. Make sure your blood sugar is controlled, and blood pressure is controlled. 所有这些都可以降低你的风险."