SARS-CoV-2 Infection Association with Atherosclerotic Plaque Progression at Coronary CT Angiography and Adverse Cardiovascular Events

https://pubs.rsna.org/doi/10.1148/radiol.240876

created by AcornAl on 04/02/2025 at 18:22 UTC

46 upvotes, 4 top-level comments (showing 4)

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Comment by AutoModerator at 04/02/2025 at 18:22 UTC

1 upvotes, 0 direct replies

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Comment by mxbx at 04/02/2025 at 19:45 UTC

11 upvotes, 1 direct replies

Put simply: COVID-19 infection is linked to faster buildup of dangerous plaques in the coronary arteries, which supply blood to the heart. A study of 803 patients found that those who had COVID-19 showed faster plaque growth, especially in non-calcified plaques, and were more likely to develop high-risk plaques.

These plaques were also more prone to inflammation. Patients with COVID-19 had a higher chance of serious heart issues, like heart attacks or needing procedures to fix blocked arteries.

This suggests COVID-19 may increase the risk of heart disease by accelerating plaque progression in the coronary arteries.

Comment by AcornAl at 04/02/2025 at 18:25 UTC

7 upvotes, 0 direct replies

Abstract

Background

Patients with acute SARS-CoV-2 infection are reportedly at increased risk for future cardiovascular events; the mechanism underlying this risk remains unclear.

Purpose

To evaluate the impact of SARS-CoV-2 infection on coronary inflammation and plaques by using coronary CT angiography (CCTA) and the impact on clinical outcomes.

Materials and Methods

This retrospective analysis of a prospective study included consecutive patients who underwent serial CCTA between September 2018 and October 2023. The quantitative total and compositional percent atheroma volume (PAV) and annualized PAV change, presence of high-risk plaque, and attenuation of lesion-specific pericoronary adipose tissue (PCAT) at baseline and follow-up were compared between lesions in patients with and without SARS-CoV-2 infection. Relationships between SARS-CoV-2 infection and target lesion failure, which is a composite of cardiac death, target lesion myocardial infarction, and clinically driven target lesion revascularizations, were assessed with Cox models and log-rank tests.

Results

In 803 patients (mean age, 63.9 years ± 10.1 [SD]; 543 [67.6%] male patients), 2108 coronary artery lesions were evaluated in patients with SARS-CoV-2 infection (n = 690) and 480 coronary artery lesions were evaluated in patients without SARS-CoV-2 infection (n = 113). Compared with lesions in patients without SARS-CoV-2 infection, lesions in patients with SARS-CoV-2 infection demonstrated more rapid progression of overall PAV (0.90% per year ± 0.91 vs 0.62% per year ± 0.68, respectively; P < .001) and noncalcified PAV (0.78% per year ± 0.79 vs 0.42% per year ± 0.45, respectively; P < .001). The incidence of becoming high-risk plaque (21.0% [442 of 2108] vs 15.8% [76 of 480]; P = .03) and PCAT attenuation of −70.1 HU or higher (27.1% [571 of 2108] vs 19.8% [95 of 480]; P < .001) at follow-up was also greater in lesions in patients with SARS-CoV-2 infection (P < .001), despite similar prevalence at baseline. Lesions in patients with COVID-19 had a higher risk of target lesion failure (10.4% vs 3.1%, respectively; adjusted hazard ratio, 2.90; 95% CI: 1.68, 5.02; P < .001).

Conclusion

SARS-CoV-2 infection was associated with a more rapid progression of lesion-based plaque volume and an increase in incidence of becoming high-risk plaque. Coronary plaques among patients who experienced COVID-19 were more prone to having an elevated risk of target lesion failure.

Clinical trial registration no. NCT05380622

There was a corresponding editorial written too:

COVID-19 Infection and Coronary Plaque Progression: An Early Warning of a Potential Public Health Crisis

Comment by TonyNickels at 05/02/2025 at 05:34 UTC

3 upvotes, 0 direct replies

What protective measures can be taken? Everyone accumulates plaque as they age sadly.