Mechanistic registry to study whether infection with Corona Virus Disease 2019 (COVID-19) alters atherosclerotic plaque progression

研究 2019 年冠状病毒病 (COVID-19) 感染是否会改变动脉粥样硬化斑块进展的机制登记

• 批准号: 10280423
• 负责人: JAGAT NARULA
• 金额: $ 162.06万
• 依托单位: WEILL MEDICAL COLL OF CORNELL UNIV
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-06 至 2021-09-07
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10280423
• 关键词: 2019-nCoV; Acute; Anatomy; Area; Arterial Fatty Streak; Atherosclerosis; Blood Vessels; COVID-19; COVID-19 patient; Cardiac; Cardiology; Cause of Death; Cholesterol; Clinical; Clinical Immunology; Coronary; Coronary Arteriosclerosis; Coronary artery; Data Collection; Deposition; Development; Diagnostic; Economics; Enrollment; Ethnic Origin; Event; Fatty acid glycerol esters; Foundations; Growth; Infection; Inflammation; Inflammatory; Inflammatory Response; Injury; Laboratories; Laboratory Markers; Link; Measurement; Measures; Methods; Multicenter Trials; Neighborhoods; New York City; Pathway interactions; Patients; Physicians; Population Density; Preventive; Preventive care; Process; Psychosocial Factor; Race; Recording of previous events; Registries; Reporting; Research Personnel; Residual state; Risk; Risk Assessment; Role; SARS-CoV-2 infection; Socioeconomic Factors; Stenosis; Testing; United States; Viral; Virus; Virus Diseases; X-Ray Computed Tomography; attenuation; coronary computed tomography angiography; coronavirus disease; cytokine; deprivation; ethnic diversity; experience; high risk; improved; indexing; inflammatory marker; inflammatory milieu; knowledge base; mortality; novel; novel coronavirus; pandemic disease; participant enrollment; promoter; racial and ethnic; racial diversity; remdesivir; socioeconomics; systemic inflammatory response; thrombotic; urban setting

Project Summary / Abstract The primary objective of the corona virus disease 2019 (COVID-19) (COVID-CT) registry is to determine if infection with the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the virus which causes COVID-19, results in marked progression of coronary atherosclerotic plaque in patients with previously defined anatomic coronary artery disease (CAD). COVID-19 induces a pro-inflammatory cytokine release and pro- thrombotic processes that we hypothesize will accelerate atherosclerotic plaque progression. Coronary computed tomographic angiography (CCTA) is a robust noninvasive method uniquely capable of measuring angiographic stenosis and quantifying and characterizing atherosclerotic plaque. Our group has extensive experience in large multicenter trials and registries using CCTA to identify key atherosclerotic plaque features associated with progression and major CAD events. Moreover, we propose use of a novel CT marker of coronary artery inflammation - the perivascular fat attenuation index (FAI) – a marker highly predictive of acute CAD events and to assess serial changes in coronary inflammation. COVID-19 is rapidly becoming a leading cause of death with substantial evidence that pre-existing CAD increases risk of serious illness and mortality from COVID-19. By enrolling patients with high risk, atherosclerotic plaque, findings from the COVID-CT registry will inform this link between the inflammatory response sustained during COVID-19 to accelerated atherosclerotic plaque progression. If our hypotheses are confirmed, then clinicians and patients will have clear information that viral infections, such as SARS-CoV-2, alter the inflammatory milieu and accelerate progression of atherosclerosis. Importantly, a connection between COVID- 19 and CAD will broadly impact preventive risk assessment for the ~7 million patients infected with SARS-CoV- 2 and millions more yet to be tested in the United States. To date, evidence is lacking as to whether the COVID-19 results in marked atherosclerotic plaque progression among racially and ethnically diverse patients with CCTA-defined CAD who reside across a socioeconomically- diverse, urban setting. The present proposal constitutes a comprehensive approach assessing the clinical importance of atherosclerotic plaque progression following COVID-19. Currently, the implications of epicardial coronary injury following SARS-CoV-2 infection is unknown. Yet, the inflammatory pathway of atherosclerotic plaque progression is well studied and, as such, our hypotheses are supported by this knowledge base. The proposed COVID-19 registry is poised to provide an improved mechanistic understanding of the role of viral infection on alterations in atherosclerotic plaque.

项目总结/摘要 2019冠状病毒病（COVID-19）（COVID-CT）登记的主要目的是确定 严重急性呼吸道综合征冠状病毒2型（SARS-CoV-2）感染， COVID-19导致先前定义的患者冠状动脉粥样硬化斑块显著进展 解剖型冠状动脉疾病（CAD）。COVID-19诱导促炎细胞因子释放和促炎细胞因子释放。 我们假设血栓形成过程会加速动脉粥样硬化斑块的进展。冠状 计算机断层扫描血管造影术（CCTA）是一种强大的非侵入性方法， 血管造影狭窄和量化和表征动脉粥样硬化斑块。我们的团队拥有广泛的 使用CCTA识别关键动脉粥样硬化斑块特征的大型多中心试验和登记研究的经验 与疾病进展和重大CAD事件相关。此外，我们建议使用一种新的冠状动脉CT标记物， 动脉炎症-血管周围脂肪衰减指数（FAI）-高度预测急性CAD事件的标志物 并评估冠状动脉炎症的一系列变化。 COVID-19正在迅速成为死亡的主要原因，有大量证据表明，既存CAD 增加COVID-19导致的严重疾病和死亡风险。通过招募高风险、动脉粥样硬化 斑块，COVID-CT登记研究的结果将告知炎症反应持续之间的联系 加速了动脉粥样硬化斑块的进展。如果我们的假设被证实， 临床医生和患者将有明确的信息，病毒感染，如SARS-CoV-2，改变 炎症环境和加速动脉粥样硬化进展。重要的是，COVID- 19和CAD将广泛影响约700万SARS-CoV感染患者的预防风险评估， 2和数百万人尚未在美国进行测试。 到目前为止，缺乏证据表明COVID-19是否会导致显著的动脉粥样硬化斑块进展 在居住在社会经济- 多样的城市环境目前的建议构成了一个全面的方法，评估临床 COVID-19后动脉粥样硬化斑块进展的重要性。目前，心外膜的影响 SARS-CoV-2感染后的冠状动脉损伤尚不清楚。然而，动脉粥样硬化的炎症途径 牙菌斑的进展已被充分研究，因此，我们的假设得到了这一知识基础的支持。的 拟议的COVID-19登记处准备提供对病毒作用的更好的机械理解 感染对动脉粥样硬化斑块改变的影响。