Article Impact Level: HIGH Data Quality: STRONG Summary of European Heart Journal, ehae639. https://doi.org/10.1093/eurheartj/ehae639 Dr. Yiyi Xu et al.
Points
- This study assessed cardiovascular and cerebrovascular risks following COVID-19 vaccination in a cohort of over 8 million Swedish adults.
- A transient increase in the risk of myocarditis and pericarditis was observed within 1–2 weeks post-vaccination, particularly in younger males.
- Increased risks of extrasystoles were noted after the first and second doses, especially among elderly males, along with a slight increase in transient ischemic attack (TIA) risk in elderly individuals.
- No significant increase was found for stroke or other arrhythmias following vaccination.
- Complete vaccination, especially after the third dose, was associated with a reduced risk of several severe cardiovascular outcomes, underscoring the overall protective benefits of COVID-19 vaccination.
Summary
This study aimed to assess the risks of cardiovascular and cerebrovascular events following COVID-19 vaccination in a nationwide cohort of Swedish adults (n = 8,070,674). The investigation focused on the occurrence of myocarditis, pericarditis, dysrhythmias, heart failure, myocardial infarction, and cerebrovascular events, including transient ischemic attack (TIA) and stroke, in specific time windows following each vaccine dose. Cox regression models were used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs), adjusted for potential confounders.
The results showed a transient increase in the risk of myocarditis and pericarditis within 1–2 weeks post-mRNA COVID-19 vaccination, particularly among younger males. Increased risks were also observed for extrasystoles following dose one (HR 1.17; 95% CI 1.06–1.28) and dose two (HR 1.22; 95% CI 1.10–1.36), especially among the elderly and males. Additionally, there was a slight increase in the risk of TIA (HR 1.13; 95% CI 1.05–1.23), primarily in elderly individuals, while no significant increase was observed for stroke or other arrhythmias.
Notably, complete vaccination was associated with a decreased risk of severe cardiovascular outcomes, particularly after the third dose, with hazard ratios ranging from 0.69 to 0.81. These findings highlight that although some transient cardiovascular risks are associated with COVID-19 vaccination, the protective benefits of reducing severe COVID-19-related cardiovascular complications outweigh these risks, emphasizing the importance of complete vaccination.
Link to the article: https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehae639/7795309
References Xu, Y., Li, H., Santosa, A., Wettermark, B., Fall, T., Björk, J., Börjesson, M., Gisslén, M., & Nyberg, F. (2024). Cardiovascular events following coronavirus disease 2019 vaccination in adults: A nationwide Swedish study. European Heart Journal, ehae639. https://doi.org/10.1093/eurheartj/ehae639
