Cardiol Res

Cardiology Research, ISSN 1923-2829 print, 1923-2837 online, Open Access

Article copyright, the authors; Journal compilation copyright, Cardiol Res and Elmer Press Inc

Journal website https://www.cardiologyres.org

Original Article

Volume 14, Number 3, June 2023, pages 221-227

Coronary Artery Disease as an Independent Predictor of Cardiovascular Mortality in COVID-19 Patients

Figure 1. Flow chart of the study’s patient population. CAD: coronary artery disease; LAD: left anterior descending; PCI: percutaneous coronary intervention; CABG: coronary artery bypass graft; SARS-CoV-2: severe acute respiratory syndrome coronavirus 2.

Figure 2. All-cause mortality incidence by coronary artery disease classification. Bars illustrate mean ± SD. CAD: coronary artery disease; LAD: left anterior descending; SD: standard deviation.

Figure 3. Cardiovascular mortality incidence by coronary artery disease classification. Bars illustrate mean ± SD. CAD: coronary artery disease; LAD: left anterior descending; SD: standard deviation.

**Table 1.** Demographics of Study Cohort
Factors	Group	Without CAD (N = 2,825)	With CAD (N = 511)	P-value
BMI: body mass index; CABG: coronary artery bypass graft; CKD: chronic kidney disease; COPD: chronic obstructive pulmonary disease; HIV: human immunodeficiency virus; IQR: interquartile range; LAD: left anterior descending; PCI: percutaneous coronary intervention.
Age (years; median (IQR))		61.00 (48.00 - 73.00)	71.00 (63.00 - 80.00)	< 0.001
Gender (n, %)	Male	1,430 (50.6)	311 (60.9)	< 0.001
	Female	1,395 (49.4)	200 (39.1)	< 0.001
BMI (kg/m²; median (IQR))		30.10 (25.50 - 35.58)	29.20 (25.10 - 34.20)	0.004
Comorbidities (n, %)	CKD	No	2,482 (87.9)	376 (73.6)	< 0.001
		Yes	341 (12.1)	135 (26.4)
	COPD/asthma	No	2,455 (87.0)	406 (79.5)	< 0.001
		Yes	368 (13.0)	105 (20.5)
	Diabetes	No	1,800 (63.8)	208 (40.7)	< 0.001
		Yes	1,023 (36.2)	303 (59.3)
	Heart failure	No	2,564 (90.8)	324 (63.4)	< 0.001
		Yes	261 (9.2)	187 (36.6)
	Hypertension	No	1,169 (41.4)	88 (17.2)	< 0.001
		Yes	1,654 (58.6)	423 (82.8)
	History of stroke	No	2,601 (92.1)	428 (83.8)	< 0.001
		Yes	222 (7.9)	83 (16.2)
	Cirrhosis	No	2,757 (97.7)	496 (97.1)	0.434
		Yes	66 (2.3)	15 (2.9)
	HIV	No	2,806 (99.4)	508 (99.4)	1
		Yes	16 (0.6)	3 (0.6)
Coronary interventions (n, %)	CABG	No		352 (72.3)
		Yes		135 (27.7)
	PCI	No		240 (49.3)
		Yes		247 (50.7)
Coronary disease (n, %)	Left main + LAD	No		279 (57.3)
		Yes		208 (42.7)

Table 1. Demographics of Study Cohort

Factors

Group

Without CAD (N = 2,825)

With CAD (N = 511)

P-value

BMI: body mass index; CABG: coronary artery bypass graft; CKD: chronic kidney disease; COPD: chronic obstructive pulmonary disease; HIV: human immunodeficiency virus; IQR: interquartile range; LAD: left anterior descending; PCI: percutaneous coronary intervention.

Age (years; median (IQR))

61.00 (48.00 - 73.00)

71.00 (63.00 - 80.00)

< 0.001

Gender (n, %)

Male

1,430 (50.6)

311 (60.9)

< 0.001

Female

1,395 (49.4)

200 (39.1)

< 0.001

BMI (kg/m²; median (IQR))

30.10 (25.50 - 35.58)

29.20 (25.10 - 34.20)

0.004

Comorbidities (n, %)

CKD

2,482 (87.9)

376 (73.6)

< 0.001

Yes

341 (12.1)

135 (26.4)

COPD/asthma

2,455 (87.0)

406 (79.5)

< 0.001

Yes

368 (13.0)

105 (20.5)

Diabetes

1,800 (63.8)

208 (40.7)

< 0.001

Yes

1,023 (36.2)

303 (59.3)

Heart failure

2,564 (90.8)

324 (63.4)

< 0.001

Yes

261 (9.2)

187 (36.6)

Hypertension

1,169 (41.4)

88 (17.2)

< 0.001

Yes

1,654 (58.6)

423 (82.8)

History of stroke

2,601 (92.1)

428 (83.8)

< 0.001

Yes

222 (7.9)

83 (16.2)

Cirrhosis

2,757 (97.7)

496 (97.1)

0.434

Yes

66 (2.3)

15 (2.9)

HIV

2,806 (99.4)

508 (99.4)

Yes

16 (0.6)

3 (0.6)

Coronary interventions (n, %)

CABG

352 (72.3)

Yes

135 (27.7)

PCI

240 (49.3)

Yes

247 (50.7)

Coronary disease (n, %)

Left main + LAD

279 (57.3)

Yes

208 (42.7)

**Table 2.** Logistic Regression Analysis of Coronary Artery Disease and Incidence of All-Cause Mortality
Factor	Odds ratio (95% CI)	P-value
BMI: body mass index; CAD: coronary artery disease; CI: confidence interval; CKD: chronic kidney disease; COPD: chronic obstructive pulmonary disease; ESRD: end-stage renal disease; HIV: human immunodeficiency virus.
Age	1.05 (1.03 - 1.08)	< 0.001
BMI	0.98 (0.95 - 1.02)	0.345
Female gender	0.51 (0.30 - 0.86)	0.011
Comorbidity
CAD	1.51 (0.15 - 15)	0.723
Cirrhosis	1.71 (0.97 - 3.01)	0.065
CKD/ESRD	1.33 (0.77 - 2.28)	0.307
COPD/asthma	1.08 (0.81 - 1.44)	0.61
Diabetes	1.15 (0.92 - 1.44)	0.21
Heart failure	1.00 (0.60 - 1.67)	0.997
HIV	0.52 (0.07 - 4.06)	0.53
Hypertension	1.03 (0.55 - 1.93)	0.929
History of stroke	1.03 (0.54 - 1.96)	0.925

Table 2. Logistic Regression Analysis of Coronary Artery Disease and Incidence of All-Cause Mortality

Factor

Odds ratio (95% CI)

P-value

BMI: body mass index; CAD: coronary artery disease; CI: confidence interval; CKD: chronic kidney disease; COPD: chronic obstructive pulmonary disease; ESRD: end-stage renal disease; HIV: human immunodeficiency virus.

Age

1.05 (1.03 - 1.08)

< 0.001

BMI

0.98 (0.95 - 1.02)

0.345

Female gender

0.51 (0.30 - 0.86)

0.011

Comorbidity

CAD

1.51 (0.15 - 15)

0.723

Cirrhosis

1.71 (0.97 - 3.01)

0.065

CKD/ESRD

1.33 (0.77 - 2.28)

0.307

COPD/asthma

1.08 (0.81 - 1.44)

0.61

Diabetes

1.15 (0.92 - 1.44)

0.21

Heart failure

1.00 (0.60 - 1.67)

0.997

HIV

0.52 (0.07 - 4.06)

0.53

Hypertension

1.03 (0.55 - 1.93)

0.929

History of stroke

1.03 (0.54 - 1.96)

0.925

**Table 3.** Logistic Regression for Coronary Artery Disease and Incidence of Cardiovascular Mortality
Factor	Odds ratio (95% CI)	P-value
BMI: body mass index; CAD: coronary artery disease; CI: confidence interval; CKD: chronic kidney disease; COPD: chronic obstructive pulmonary disease; ESRD: end-stage renal disease; HIV: human immunodeficiency virus.
Age	0.99 (0.97 - 1.02)	0.612
BMI	0.92 (0.87 - 0.99)	0.021
Female gender	1.05 (0.47 - 2.35)	0.9
Comorbidity
CAD	6.89 (2.71 - 17.5)	< 0.001
Cirrhosis	0 (0 - inf)	0.98
CKD/ESRD	0.879 (0.337 - 2.29)	0.791
COPD/asthma	0.512 (0.151 - 1.74)	0.283
Diabetes	1.40 (0.59 - 3.36)	0.444
Heart failure	1.34 (0.484 - 3.73)	0.569
HIV	0 (0 - inf)	0.99
Hypertension	0.458 (0.182 - 1.15)	0.097
History of stroke	0.908 (0.306 - 2.69)	0.861

Table 3. Logistic Regression for Coronary Artery Disease and Incidence of Cardiovascular Mortality

Factor

Odds ratio (95% CI)

P-value

Age

0.99 (0.97 - 1.02)

0.612

BMI

0.92 (0.87 - 0.99)

0.021

Female gender

1.05 (0.47 - 2.35)

0.9

Comorbidity

CAD

6.89 (2.71 - 17.5)

< 0.001

Cirrhosis

0 (0 - inf)

0.98

CKD/ESRD

0.879 (0.337 - 2.29)

0.791

COPD/asthma

0.512 (0.151 - 1.74)

0.283

Diabetes

1.40 (0.59 - 3.36)

0.444

Heart failure

1.34 (0.484 - 3.73)

0.569

HIV

0 (0 - inf)

0.99

Hypertension

0.458 (0.182 - 1.15)

0.097

History of stroke

0.908 (0.306 - 2.69)

0.861

**Table 4.** Distribution of Cardiovascular Causes of Mortality
Factor	Group	No CAD (N = 244)	CAD (N = 77)	P-value
CAD: coronary artery disease; PE: pulmonary embolism; STEMI: ST-elevation myocardial infarction.
Cause of mortality (n, %)	Non-cardiac	226 (92.6)	60 (77.9)	0.001
	Cardiovascular	18 (7.4)	17 (22.1)
Cardiovascular cause of mortality (n, %)	Cardiogenic shock	5 (27.8)	5 (29.4)	0.01
	Endocarditis	1 (5.6)	0 (0.0)
	PE	1 (5.6)	1 (5.9)
	STEMI	0 (0.0)	7 (41.2)
	Stroke	3 (16.7)	3 (17.6)
	Supraventricular tachycardia without P-waves	1 (5.6)	0 (0.0)
	Ventricular tachycardia	7 (38.9)	1 (5.9)

Table 4. Distribution of Cardiovascular Causes of Mortality

Factor

Group

No CAD (N = 244)

CAD (N = 77)

P-value

CAD: coronary artery disease; PE: pulmonary embolism; STEMI: ST-elevation myocardial infarction.

Cause of mortality (n, %)

Non-cardiac

226 (92.6)

60 (77.9)

0.001

Cardiovascular

18 (7.4)

17 (22.1)

Cardiovascular cause of mortality (n, %)

Cardiogenic shock

5 (27.8)

5 (29.4)

0.01

Endocarditis

1 (5.6)

0 (0.0)

1 (5.6)

1 (5.9)

STEMI

0 (0.0)

7 (41.2)

Stroke

3 (16.7)

3 (17.6)

Supraventricular tachycardia without P-waves

1 (5.6)

0 (0.0)

Ventricular tachycardia

7 (38.9)

1 (5.9)