How has COVID-19 affected heart attack mortality in the US?

According to new research from scientists at Cedars-Sinai Medical Center in Los Angeles, as the number of COVID-19 infections increased during the pandemic, so did the number of deaths from heart attacks, with the largest increase among adults aged 25-44.

“The a sharp increase in heart attacks during the pandemic reversed what had been a steady improvement in heart disease mortality that had lasted the previous decade,” said Dr. Yi Hui Yeo, the study’s first author and a physician scientist at Cedars-Sinai. “We are still learning the many ways in which COVID-19 affects the body, regardless of age, gender, ethnicity or race.”

Scientists around the country and the world continue to publish results showing that SARS-CoV-2 infections increase the risk of other serious diseases such as stroke, nerve damage and some autoimmune diseases.

While other infections, such as the flu, are known to lead to a small increase in the risk of heart attacks, the Cedars-Sinai researchers said, they couldn’t find anything like the jump in deaths associated with the COVID-19 pandemic. Among their findings, published in the peer-reviewed Journal of Medical Virology:

The number of U.S. deaths related to heart attacks, or acute myocardial infarctions as they are medically known, rose 14% to 164,096 in the first year of the pandemic, from April 1, 2020, to March 31, 2021.

In the second year of the pandemic, a sharp increase in heart attacks has disrupted models used to predict the number of people who will die from these events. Fatal heart attacks among adults aged 25-44 rose 29.9% from projections. Heart attack mortality increased by 19.6% among adults aged 45-64 and by 13.7% in those aged 65 and older.

Cedars-Sinai researchers found that extremely high heart attack death rates persisted throughout the pandemic, including the possibility that COVID-19 could trigger or accelerate coronary heart disease. The scientists said more research is needed to pinpoint the risks.

“There is something very different about how this virus affects cardiac risk,” said Dr. Susan Cheng, director of the Institute for Research on Healthy Aging in the Smithsonian Heart Institute’s Division of Cardiology and senior and co-author of the study. “The difference is likely due to a combination of stress and inflammation arising from predisposing factors and how this virus biologically interacts with the cardiovascular system.”

To be sure, Cheng and other researchers said the behavioral health problems associated with the pandemic — job loss, isolation, the unexpected death of a relative or other pressures — could also cause acute or chronic stress that leads to heart disease.

Because of the increased risk of stress, many Americans have dropped their exercise habits and may have missed medical exams that could have detected problems, said a separate team of Cedars-Sinai researchers who reported in August that the COVID-19 is associated with an increased risk of stroke.

Individuals who were vaccinated were 200 times less likely to have a stroke after experiencing a respiratory illness. Those with severe cases of COVID-19 were at significantly higher risk of inflammation, blood clots and heart disease

Dr. Nancy Sicot, chair of the neurology department and chair emeritus of the Women’s Guild of Neurology at Cedars-Sinai, strongly recommended vaccines for high-risk individuals. This includes those with lung or cardiovascular disease, high blood pressure, high cholesterol, diabetes, a previous stroke, people who are immunocompromised, and people age 65 and older.