No decline in cardiovascular events seen with COVID-19 vaccine after acute coronary syndromes

Patients who have received at least one COVID-19 vaccine dose after acute coronary syndromes do not have a reduced risk for cardiovascular events, according to a research letter published online May 30 in JAMA Network Open.

Henrique Andrade R. Fonseca, Ph.D., from Hospital Israelita Albert Einstein in São Paulo, Brazil, and colleagues conducted a secondary analysis of the Vaccination Against Influenza to Prevent Cardiovascular Events After Acute Coronary Syndromes trial.

The incidence of cardiopulmonary events was compared in patients who received versus did not receive COVID-19 vaccination in Brazil. Data were included for 1,801 participants; the primary analysis included 1,665 individuals who did not have cardiopulmonary events during the first 90 days. Overall, 50.2% had received at least one COVID-19 vaccine dose.

The researchers found that the incidence of the primary end point (all-cause death, myocardial infarction, stroke, hospitalization for unstable angina, hospitalization for heart failure, urgent coronary revascularization, or hospitalization for respiratory infections) was 9.37 versus 4.81 events per 100 patient-years for unvaccinated individuals versus those who had received at least one vaccine dose.

The incidence of major adverse cardiovascular events was not significantly reduced with vaccination. Similar findings were seen for the adjusted incidence of the primary composite end point and all-cause death.

"Residual confounding or unmeasured variables could explain the findings," the authors write.

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