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.
PLoS One. 2023 Sep 1;18(9):e0291090. doi: 10.1371/journal.pone.0291090. eCollection 2023.
COVID-19 vaccines are highly immunogenic but cardiovascular effects of these vaccines have not been properly elucidated.
To determine impact of COVID-19 vaccination on mortality following acute myocardial infarction (AMI).
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.
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.
COVID-19 vaccines have shown to decrease all-cause mortality at 30 days and six months following AMI.
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。
确定 COVID-19 疫苗接种对急性心肌梗死(AMI)后死亡率的影响。
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。
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)。
COVID-19 疫苗接种可降低 AMI 后 30 天和 6 个月的全因死亡率。