The relationship between severe acute respiratory syndrome coronavirus 2 omicron variant epidemic and acute myocardial infarction: A self-controlled case series study

Abstract

Background

The coronavirus disease 2019 (COVID-19) pandemic has led to various complications, including cardiovascular events. Despite the widespread impact of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant in 2022, no studies have evaluated the relationship between the Omicron variant epidemic and acute myocardial infarction (AMI).

Methods

We utilized a Japanese claims database to identify patients diagnosed with COVID-19 between January 1, 2022, and December 31, 2022. We also identified patients who developed AMI within 90 days before and after their COVID-19 diagnosis. A self-controlled case series (SCCS) analysis evaluated the incidence rate ratio (IRR) for AMI.

Results

Of the 360,589 patients with COVID-19, 759 were diagnosed with AMI. Excluding the day of exposure, the SCCS analysis showed an IRR for AMI of 6.65 (95 % confidence interval [CI]: 4.66–9.48, P < 0.001) for the 1st week, 1.90 (95 % CI: 1.05–3.50, P = 0.03) for the 2 nd week, and 0.95 (95 % CI: 0.52–1.72, P = 0.87) for the 3rd and 4th weeks following COVID-19. Including the day of exposure, the IRR was 77.4 (95 % CI: 63.2–94.9, P < 0.001) for the 1st week, 1.90 (95 % CI: 1.05–3.50, P = 0.03) for the 2 nd week, and 0.95 (95 % CI: 0.52–1.72, P = 0.87) for the 3rd and 4th weeks following COVID-19.

Conclusions

This study showed that the SARS-CoV-2 Omicron variant epidemic increased AMI incidence. These findings highlight AMI as a COVID-19 characteristic, emphasize the importance of SARS-CoV-2 vaccination, and underline the need for continued vigilance, even with variant changes.