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COVID-19 疫苗接种对急性心肌梗死后死亡率的影响。

Impact of COVID-19 vaccination on mortality after acute myocardial infarction.

机构信息

Department of Cardiology, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research, Delhi, India.

Department of Cardiology, ESIC Medical College and Hospital, Faridabad, Haryana.

出版信息

PLoS One. 2023 Sep 1;18(9):e0291090. doi: 10.1371/journal.pone.0291090. eCollection 2023.

Abstract

BACKGROUND

COVID-19 vaccines are highly immunogenic but cardiovascular effects of these vaccines have not been properly elucidated.

OBJECTIVES

To determine impact of COVID-19 vaccination on mortality following acute myocardial infarction (AMI).

METHODS

This was a single center retrospective observation study among patients with AMI enrolled in the the North India ST-Elevation Myocardial Infarction (NORIN-STEMI) registry. In all the enrolled patients, data regarding patient's vaccination status including details on type of vaccine, date of vaccination and adverse effects were obtained. All enrolled subjects were followed up for a period of six months. The primary outcome of the study was all-cause mortality both at one month and at six months of follow-up. Propensity-weighted score logistic regression model using inverse probability of treatment weighting was used to determine the impact of vaccination status on all-cause mortality.

RESULTS

A total of 1578 subjects were enrolled in the study of whom 1086(68.8%) were vaccinated against COVID-19 while 492(31.2%) were unvaccinated. Analysis of the temporal trends of occurrence of AMI post vaccination did not show a specific clustering of AMI at any particular time. On 30-day follow-up, all-cause mortality occurred in 201(12.7%) patients with adjusted odds of mortality being significantly lower in vaccinated group (adjusted odds ratio[aOR]: 0.58, 95% CI: 0.47-0.71). Similarly, at six months of follow-up, vaccinated AMI group had lower odds of mortality(aOR: 0.54, 95% CI: 0.44 to 0.65) as compared to non-vaccinated group.

CONCLUSIONS

COVID-19 vaccines have shown to decrease all-cause mortality at 30 days and six months following AMI.

摘要

背景

COVID-19 疫苗具有高度的免疫原性,但这些疫苗对心血管的影响尚未得到充分阐明。

目的

确定 COVID-19 疫苗接种对急性心肌梗死(AMI)后死亡率的影响。

方法

这是一项针对 NORIN-STEMI 注册研究中 AMI 患者的单中心回顾性观察研究。在所有纳入的患者中,获取了患者的疫苗接种状况数据,包括疫苗类型、接种日期和不良反应的详细信息。所有纳入的患者均随访 6 个月。研究的主要结局是在 1 个月和 6 个月的随访时的全因死亡率。采用逆概率处理加权的倾向评分逻辑回归模型,确定疫苗接种状况对全因死亡率的影响。

结果

共纳入 1578 例患者,其中 1086 例(68.8%)接种了 COVID-19 疫苗,492 例(31.2%)未接种疫苗。对 COVID-19 疫苗接种后 AMI 发生的时间趋势分析未显示出特定时间 AMI 的特定聚集。在 30 天随访时,201 例(12.7%)患者发生全因死亡,接种组的死亡调整优势比(adjusted odds ratio[aOR])明显较低(调整后比值比[aOR]:0.58,95%置信区间:0.47-0.71)。同样,在 6 个月随访时,与未接种疫苗组相比,接种 AMI 组的死亡率较低(aOR:0.54,95%置信区间:0.44 至 0.65)。

结论

COVID-19 疫苗接种可降低 AMI 后 30 天和 6 个月的全因死亡率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f63/10473468/3b10c177cb1e/pone.0291090.g001.jpg

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