Houghton Damon E, Wysokinski Waldemar E, Padrnos Leslie J, Shah Surbhi, Wysokinska Ewa, Pruthi Rajiv, Ghorbanzadeh Atefeh, Ashrani Aneel, Sridharan Meera, McBane Robert D, Padmanabhan Anand, Casanegra Ana I
Department of Cardiovascular Diseases, Division of Vascular Medicine, Mayo Clinic, Rochester, Minnesota, United States.
Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, Minnesota, United States.
Am J Hematol. 2023 Apr;98(4):566-570. doi: 10.1002/ajh.26848. Epub 2023 Jan 28.
Patients with thrombophilia remain concerned about venous thromboembolism (VTE) risk with COVID-19 vaccinations. The aim of this study was to examine VTE outcomes in patients with inherited or acquired thrombophilia who were vaccinated for COVID-19. Vaccinated patients ≥18 years between November 1, 2020 and November 1, 2021 were analyzed using electronic medical records across the Mayo Clinic enterprise. The primary outcome was imaging confirmed acute VTE occurring 90 days before and after the date of the first vaccine dose. Thrombophilia patients were identified through laboratory testing results and ICD-10 codes. A total of 792 010 patients with at least one COVID-19 vaccination were identified. Six thousand sixty-seven of these patients were found to have a thrombophilia, among whom there was a total of 39 VTE events after compared to 51 VTE events before vaccination (0.64% vs. 0.84%, p = .20). In patients with Factor V Leiden or prothrombin gene mutation, VTE occurred in 27 patients before and in 29 patients after vaccination (0.61 vs. 0.65%, p = .79). In patients with antiphospholipid syndrome, VTE occurred in six patients before and four patients after vaccination (0.59% vs. 0.39%, p = .40). No difference was observed in the overall VTE rate when comparing the postvaccination 90 days to the prevaccination 90 days, adjusted hazard ratio 0.81 (95% confidence interval: 0.53-1.23). In this subgroup of COVID-19 vaccinated patients with thrombophilia, there was no increased risk for acute VTE postvaccination compared to the prevaccination timeframe. These results are consistent with prior studies and should offer additional reassurance to patients with inherited or acquired thrombophilia.
患有血栓形成倾向的患者仍担心接种新冠病毒疫苗后的静脉血栓栓塞（VTE）风险。本研究的目的是检查接种新冠病毒疫苗的遗传性或获得性血栓形成倾向患者的VTE结局。使用梅奥诊所企业的电子病历对2020年11月1日至2021年11月1日期间年龄≥18岁的接种疫苗患者进行分析。主要结局是影像证实的急性VTE在首次接种疫苗日期前后90天内发生。通过实验室检测结果和ICD - 10编码识别血栓形成倾向患者。共识别出792010名至少接种过一剂新冠病毒疫苗的患者。其中6067名患者被发现患有血栓形成倾向，与接种疫苗前的51例VTE事件相比，接种疫苗后共有39例VTE事件（分别为0.64%和0.84%，p = 0.20）。在携带因子V莱顿突变或凝血酶原基因突变的患者中，接种疫苗前有27例发生VTE，接种疫苗后有29例发生VTE（分别为0.61%和0.65%，p = 0.79）。在抗磷脂综合征患者中，接种疫苗前有6例发生VTE，接种疫苗后有4例发生VTE（分别为0.59%和0.39%，p = 0.40）。将接种疫苗后90天与接种疫苗前90天的总体VTE发生率进行比较时，未观察到差异，调整后的风险比为0.81（95%置信区间：0.53 - 1.23）。在这一接种新冠病毒疫苗的血栓形成倾向患者亚组中，与接种疫苗前相比，接种疫苗后急性VTE风险没有增加。这些结果与先前的研究一致，应该能为遗传性或获得性血栓形成倾向患者提供更多的安心保障。
