Lin Emily Pei-Ying, Hsu Chih-Yuan, Mishra Sanjay, Griffiths Elizabeth A, Segal Brahm H, Hwang Clara, Singh Sunny R K, Balanchivadze Nino, Jani Chinmay, Mariano Melissa G, Bhatt Padmanabh S, Vieira Kendra, Yu Peter Paul, Oligino Eric J, Wise-Draper Trisha, Ferrara Elizabeth K, McKay Rana R, Nonato Taylor K, Labaki Chris, Saad Eddy, Saliby Renée-Maria, Morgans Alicia K, Nohria Anju, Puc Matthew, Accordino Melissa K, Bodin Brianne E, Nanchal Rahul, Singh Harpreet, Berg Stephanie, Mavromatis Blanche, McManus Hannah D, Halabi Susan, Choueiri Toni K, Warner Jeremy L, Shyr Yu
Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN 37232, USA.
Center for Quantitative Sciences, Vanderbilt University Medical Center, Nashville, TN 37232, USA.
Lancet Reg Health Am. 2025 Mar 6;44:101038. doi: 10.1016/j.lana.2025.101038. eCollection 2025 Apr.
Whether COVID-19 vaccination is associated with risks for cardiovascular complications after SARS-CoV-2 infection in patients with cancer is unknown. The objective of this study was to investigate the associations between the two.
This registry (COVID-19 and Cancer Consortium)-based retrospective cohort study included patients with laboratory-confirmed SARS-CoV-2 infection from the United States, Canada, and Mexico between April 2021 and December 2022. Patients without COVID-19 vaccination were assigned to the unvaccinated group and patients with ≥2 doses of COVID-19 vaccination were assigned to the fully-vaccinated group. The primary outcome was a composite of post-infectious cardiac complications, including acute myocardial infarction, other ischemic heart disease, atrial fibrillation, ventricular fibrillation, other arrhythmias, cardiomyopathy, and congestive heart failure. The secondary outcome was a composite measure of post-infectious cardiovascular events, comprising of the cardiac complications along with pulmonary embolism, deep vein thrombosis, superficial vein thrombosis, other thrombosis, and cerebrovascular stroke. Multivariable logistic regression was used for data analysis.
A total of 2729 patients were included for analyses, with 1382 in the unvaccinated group and 1347 in the fully-vaccinated group. The median age of the study population was 65 (interquartile range (IQR), 55-74) years. Overall, 1534 (56.0%) were women; 1272 (47%) were never smokers; 1639 (60%) were not obese; 2043 (75%) had stable cancer, and 446 (16%) took anticoagulants at baseline. The primary and secondary analyses showed lower risks of cardiac complications and cardiovascular events in the fully-vaccinated group, with adjusted odds ratios (aOR) of 0.66 (95% confidence interval (CI), 0.48-0.89) and 0.76 (95% CI, 0.59-0.99), respectively. The protective trend with COVID-19 vaccination was observed across infections with different dominant SARS-CoV-2 strains and in patients with or without anticoagulant use.
COVID-19 vaccination was associated with a reduced risk of cardiac complications and cardiovascular events by 34% and 24%, respectively, after SARS-CoV-2 infection in patients with cancer.
National Institutes of Health USA; National Science and Technology Council of Taiwan.
癌症患者感染新型冠状病毒2（SARS-CoV-2）后接种新型冠状病毒肺炎（COVID-19）疫苗是否与心血管并发症风险相关尚不清楚。本研究的目的是调查两者之间的关联。
这项基于登记处（COVID-19与癌症联盟）的回顾性队列研究纳入了2021年4月至2022年12月期间来自美国、加拿大和墨西哥的实验室确诊SARS-CoV-2感染患者。未接种COVID-19疫苗的患者被分配到未接种组，接种≥2剂COVID-19疫苗的患者被分配到完全接种组。主要结局是感染后心脏并发症的综合指标，包括急性心肌梗死、其他缺血性心脏病、心房颤动、心室颤动、其他心律失常、心肌病和充血性心力衰竭。次要结局是感染后心血管事件的综合指标，包括心脏并发症以及肺栓塞、深静脉血栓形成、浅静脉血栓形成、其他血栓形成和脑血管意外。采用多变量逻辑回归进行数据分析。
共纳入2729例患者进行分析，未接种组1382例，完全接种组1347例。研究人群的中位年龄为65岁（四分位间距（IQR），55 - 74岁）。总体而言，1534例（56.0%）为女性；1272例（47%）从不吸烟；1639例（60%）不肥胖；2043例（75%）患有稳定癌症，446例（16%）在基线时服用抗凝剂。主要和次要分析显示，完全接种组发生心脏并发症和心血管事件的风险较低，调整后的优势比（aOR）分别为0.66（95%置信区间（CI），0.48 - 0.89）和0.76（95%CI，0.59 - 0.99）。在不同优势SARS-CoV-2毒株感染的患者以及使用或未使用抗凝剂的患者中，均观察到COVID-19疫苗接种的保护趋势。
癌症患者感染SARS-CoV-2后，接种COVID-19疫苗分别使心脏并发症和心血管事件的风险降低了34%和24%。
美国国立卫生研究院；台湾国家科学技术委员会。
