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

Abstract

BACKGROUND: COVID-19 vaccines have demonstrated effectiveness against SARS-CoV-2 infection, hospitalization, and mor-tality. 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.