Chen Chung-Yen, Su Ta-Chen
Department of Environmental and Occupational Medicine, National Taiwan University Hospital Yunlin Branch, Douliu, Taiwan.
Department of Environmental and Occupational Medicine, National Taiwan University Hospital, Taipei, Taiwan.
J Lipid Atheroscler. 2023 May;12(2):119-131. doi: 10.12997/jla.2023.12.2.119. Epub 2023 May 19.
Patients with a history of cardiovascular disease (CVD) who contract coronavirus disease 2019 (COVID-19) tend to have a worse prognosis and more severe cardiovascular side effects. COVID-19 vaccines, which are intended to prevent COVID-19, may also potentially reduce the severity and complications (including cardiovascular sequelae) of COVID-19, especially in patients with a history of CVD. However, there have also been reports of cardiovascular side effects from COVID-19 vaccines of various brands and types. The purpose of this study is to review the benefits and harms of COVID-19 vaccines in relation to CVD. In this thorough review of the most current evidence on the benefits and harms of COVID-19 vaccines, we present information about the characteristics of cardiovascular complications. Most of the evidence focuses on myocarditis or pericarditis, which are most strongly associated with mRNA vaccines and predominantly occur in young males within days of receiving the second dose. Meanwhile, post-vaccination myocardial infarction is more common in older males, and the first dose of adenoviral vector vaccines appears to play a greater role in this complication. This information may guide us in formulating alternative options and implementing targeted surveillance. Gaining more knowledge about the potential benefits and harms of COVID-19 vaccines will improve our ability to make informed decisions and judgments about the balance of these factors.
有心血管疾病(CVD)病史的患者感染2019冠状病毒病(COVID-19)后往往预后较差,心血管副作用也更严重。旨在预防COVID-19的COVID-19疫苗,也可能会降低COVID-19的严重程度和并发症(包括心血管后遗症),尤其是在有CVD病史的患者中。然而,也有关于各种品牌和类型的COVID-19疫苗引起心血管副作用的报道。本研究的目的是回顾COVID-19疫苗在心血管疾病方面的益处和危害。在对COVID-19疫苗益处和危害的最新证据进行全面回顾时,我们提供了有关心血管并发症特征的信息。大多数证据集中在心肌炎或心包炎上,这两种疾病与mRNA疫苗关联最为密切,主要发生在年轻男性接种第二剂疫苗后的几天内。与此同时,接种疫苗后心肌梗死在老年男性中更为常见,腺病毒载体疫苗的第一剂似乎在这种并发症中起更大作用。这些信息可能会指导我们制定替代方案并实施针对性监测。更多地了解COVID-19疫苗的潜在益处和危害,将提高我们对这些因素的平衡做出明智决策和判断的能力。