Heartbeat: hospitalisation for COVID-19 is associated with an increased risk of subsequent adverse cardiovascular events

In order to assess whether previous COVID19 infection might be associated with a higher risk of subsequent adverse cardiovascular disease (CVD) events, RaisiEstabragh and colleagues analysed incident CVD events in 17 871 UK Biobank cases with prospective followup from March 2020 to March 2021. Hospitalisation for COVID19 was associated with an increased risk of several adverse CVD events, including myocardial infarction, stroke, heart failure, atrial fibrillation, venous thromboembolism and mortality (figure 1). Risk was highest in the first 30 days after infection, but remained higher than matched controls over an average followup of 141 days. In cases with COVID19 who were not hospitalised, risk was higher only for venous thromboembolism and allcause mortality. In the accompanying editorial, Bularga and colleagues point out that the association between systemic inflammation due to respiratory infection and an increased risk of adverse CVD events was well known prior to the COVID19 pandemic. ‘However, the proportionately greater breadth and increase in cardiovascular events seen with COVID19 are exceptional and suggest more than a simple inflammatory effect. This has been hypothesised to relate to endothelial dysfunction or prothrombotic effects of COVID19 in addition to typical cardiovascular risk factors and underlying previously unrecognised coronary or structural heart disease.’ Women with Turner syndrome (TS) are at increased risk for aortic dilation and dissection, often in association with a bicuspid aortic valve. In a prospective multicentre cohort study of 89 women with TS, 38% had aortic dilation at baseline, with associated clinical risk factors of age (OR: 1.08 (95% CI 1.03 to 1.13), p<0.001), bicuspid aortic valve (BAV) (OR: 7.09 (95% CI 2.22 to 25.9), p=0.002) and systolic blood pressure (OR: