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Vaccinated Have Lower Heart, Stroke Risk From COVID
Korean nationwide data support yet another benefit of being fully vaccinated
Full vaccination against COVID-19 was associated with a reduced risk of acute myocardial infarction (MI) and ischemic stroke as secondary complications of acute infection, a study from Korea showed.
These cardiovascular events were significantly reduced in the 31 to 120 days after COVID-19 diagnosis for the fully vaccinated compared with those not vaccinated:
- Composite of hospitalizations for acute MI and ischemic stroke: adjusted HR 0.42 (95% CI 0.29-0.62)
- Acute MI: adjusted HR 0.48 (95% CI 0.25-0.94)
- Ischemic stroke: adjusted HR 0.40 (95% CI 0.26-0.63)
The reduction in post-COVID heart attacks and strokes among the fully vaccinated was observed across various subgroups. However, it did not reach statistical significance for people with a previous history of outcome events or for those with severe or critical COVID-19.
"The findings support vaccination, especially for those with risk factors for cardiovascular diseases," maintained Jaehun Jung, MD, PhD, of Gachon University College of Medicine, Incheon, Korea, and colleagues reporting in a research letter in JAMA.
It had been unclear if vaccines against SARS-CoV-2 prevent secondary complications of COVID-19, Jung's group noted.
They took advantage of nationwide data from Korea, where COVID-19 reporting is mandated and universal health care coverage is in place.
Jung told MedPage Today that the present findings are not largely different than those in an earlier study on post-acute cardiovascular manifestations of COVID-19. Using data from the U.S. Department of Veterans Affairs prior to widespread vaccine availability, investigators had estimated strokes from 30 days after infection as occurring at a rate of 4.03 per 1,000 people at 12 months; post-COVID myocardial infarctions were reported at 2.91 per 1,000 people at 12 months.
In the Korean data, the stroke rate in unvaccinated individuals was 4.59 per million person-days and the MI rate was 1.60 per million person-days in the 31 to 120 days after COVID-19 diagnosis.
That data came retrospectively from a Korean nationwide COVID-19 registry and the Korean National Health Insurance Service database. Eligible patients were adults diagnosed with COVID-19 from July 2020 to December 2021. For the primary outcome, the first 30 days had been excluded to minimize cardiovascular events occurring as complications of acute COVID-19.
Investigators compared COVID-19 patients never vaccinated (n=62,727) and those fully vaccinated (n=168,310). Fully vaccinated patients tended to be older and had more comorbidities.
Jung's group employed inverse probability of treatment weighting to control for these and other differences in patient characteristics. "A robust model was applied to mitigate the effect of such imbalances, but the possibility of unobserved bias remains," the authors cautioned.
Another limitation of the study was its reliance on diagnostic codes, which may be subject to inaccuracies.
Disclosures
Jung had no disclosures.
One study coauthor disclosed grants from bioMérieux.
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