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BNT162b2 or CoronaVac Vaccinations Are Associated With a Lower Risk of Myocardial Infarction and Stroke After SARS‐CoV‐2 Infection Among Patients With Cardiovascular Disease

  • Xuxiao Ye
  • , Vincent K. C. Yan
  • , Hei Hang Edmund Yiu
  • , Jessica J. P. Shami
  • , Wei Kang
  • , Tiantian Ma
  • , Xiwen Qin
  • , Celine S. L. Chui
  • , Francisco T. T. Lai
  • , Xue Li
  • , Eric Y. F. Wan
  • , Carlos K. H. Wong
  • , Ian C. K. Wong
  • , Esther W. Chan

Research output: Contribution to journalArticlepeer-review

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Abstract

BACKGROUND: COVID‐19 vaccines have demonstrated effectiveness against SARS‐CoV‐2 infection, hospitalization, and mortality. The association between vaccination and risk of cardiovascular complications shortly after SARS‐CoV‐2 infection among patients with cardiovascular disease remains unknown. METHODS AND RESULTS: A case–control study was conducted with cases defined as patients who had myocardial infarction or stroke within 28 days after SARS‐CoV‐2 infection between January 1, 2022 and August 15, 2022. Controls were defined as all other patients who attended any health services and were not cases. Individuals without history of cardiovascular disease were excluded. Each case was randomly matched with 10 controls according to sex, age, Charlson comorbidity index, and date of hospital admission. Adjusted odds ratio with 95% CI was estimated using conditional logistic regression. We identified 808 cases matched with 7771 controls among all patients with cardiovascular disease. Results showed that vaccination with BNT162b2 or CoronaVac was associated with a lower risk of myocardial infarction or stroke after SARS‐CoV‐2 infection with a dose–response relationship. For BNT162b2, risk decreased from 0.49 (95% CI, 0.29–0.84) to 0.30 (95% CI, 0.20–0.44) and 0.17 (95% CI, 0.08–0.34) from 1 to 3 doses, respectively. Similar trends were observed for CoronaVac, with risk decreased from 0.69 (95% CI, 0.57–0.85) to 0.42 (95% CI, 0.34–0.52) and 0.32 (95% CI, 0.21–0.49) from 1 to 3 doses, respectively. CONCLUSIONS: Vaccination with BNT162b2 or CoronaVac is associated with a lower risk of myocardial infarction or stroke after SARS‐CoV‐2 infection among patients with cardiovascular disease.
Original languageEnglish
Article numbere029291
Number of pages18
JournalJournal of the American Heart Association
Volume12
Issue number9
Early online date29 Apr 2023
DOIs
Publication statusPublished - 2 May 2023

Bibliographical note

Copyright © 2023 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Funding

This work was funded by a research grant from the Food and Health Bureau; ealth and Medical Research Fund Commissioned Research on the Novel Coronavirus Disease, The Government of the Hong Kong Special Administrative Region (Principal Investigator (WP2): E.W.C.; Ref: COVID1903011). The posts of F.T.T.L. (Francisco T.T. Lai) and I.C.K.W. (Ian C.K. Wong) were partly funded by the D24H; hence this work was partly supported by AIR@InnoHK administered by Innovation and Technology Commission. The study’s sponsor was involved in the framework of study designs and data collection via the Department of Health. The corresponding author had full access to all data in the study and took final responsibility for the decision to submit for publication.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

  1. SDG 3 - Good Health and Well-being
    SDG 3 Good Health and Well-being

Keywords

  • BNT162b2
  • CoronaVac
  • COVID-19 vaccines
  • myocardial infarction
  • stroke

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