Abstract 417: Effect Of Antiplatelets, Ace-i, And Statins On Post-covid-19 Cardiovascular Complications

Abstract

Post-COVID-19 patients are at increased risk of cardiovascular and stroke complications, especially the immediate period following infection. Beta-blockers, ACE-inhibitors, anticoagulants and antiplatelet agents are mainstay therapies for stroke patients and those with cardiovascular disease. This study aims to explore the potential benefit of these therapies in post-COVID-19 patients in prevention of cardiovascular and stroke complications. About 5134 cases were analyzed in this study. This study includes patients that were admitted for stroke of myocardial infarction who had history of COVID-19 infection within 4 weeks prior. These patients were then stratified based on their home medications including ACE-I, beta-blockers, antiplatelet and anticoagulant agents. Logistic regression and chi-square were used for analysis of data. There was no significant relationship between statin use and incident of readmission for myocardial infarction. Patients who were on antiplatelet agents were more likely to be readmitted for stroke at 1 and 4 weeks (odds ratio: 2.109 and 2.335, p value: 0.0204 and 0.0036). Patients who were on ACE-I were more likely to be readmitted for stroke at 1 and 4 weeks (odds ratio: 2.0331 and 1.945; p value: 0.0062 and 0.0055). The benefit of statin therapy in COVID-19 patients has been established previously. This is potentially due to two mechanisms: anti-inflammatory properties and lipid lowering. Our studies did not find significant relationship between statin use and incidence of re-admission for myocardial infarction. We deduce that this is due to the anti-inflammatory effect of statins in acute COVID-19, and not the lipid lowering effect. Patients who are on anti-platelet therapy are more likely to be readmitted for stroke. This is likely because they are at high risk for stroke, and COVID-19 increases their systemic inflammatory response and therefore increase stroke risk. Lastly, our study suggests there may be some relationship between ACE-I use and stroke post-COVID-19 infection.