The Influence of SARS-CoV-2 Vaccination on the Mortality and Outcomes of Patients with Both Myocardial Infarction and COVID-19
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Group
- Confirmed MI, according to the ESC Fourth Universal Definition of Myocardial Infarction [33];
- Confirmed COVID-19 based on a PCR-positive test;
- Verified vaccination status with government-approved vaccines;
- Available after discharge a minimum observation period of 1 month (for patients who were discharged to allow us to create reasonable follow-up);
- Age > 18 years.
- Any coexisting disease potentially limiting lifetime during observation (e.g., end-stage organ failure or end-stage cancer);
- Lack of primary clinical data necessary for groups comparison, e.g., glomerular filtration rate (GFR) or ejection fraction (EF).
2.2. Study Outcomes
2.3. Methods
2.4. Statical Analysis and Utilized Software
2.5. Rationale for Study Design
3. Results
3.1. Study Group
3.2. Mortality
4. Discussion
5. Study Limitations
6. Conclusions
Author Contributions
Funding
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Study Group (n = 44) | Control Group (n = 85) | p | |
---|---|---|---|
Male, n (%) | 32 (72.73%) | 59 (69.41%) | 0.70 |
STEMI, n (%) | 15 (34.09%) | 43 (50.59%) | 0.08 |
Age, years | 67 (60–75) | 71 (61–76.5) | 0.36 |
EF, % | 45 (35–50) | 50 (40–55) | 0.053 |
GFR, mL/min | 78.8 (56–95.77) | 74.39 (47.77–97.92) | 0.67 |
Diabetes, n (%) | 13 (29.55%) | 23 (27.06%) | 0.77 |
Hypertension, n (%) | 31 (70.45%) | 60 (70.59%) | 0.99 |
Hyperlipidemia, n (%) | 27 (61.36%) | 36 (42.35%) | 0.05 |
Smoking, n (%) | 8 (18.18%) | 14 (16.47%) | 0.81 |
Peripheral arterial disease, n (%) | 2 (4.55%) | 1 (1.18%) | 0.23 |
Obesity, n (%) | 3 (6.82%) | 12 (14.12%) | 0.22 |
Previous stroke, n (%) | 3 (6.82%) | 6 (7.06%) | 0.96 |
Atrial fibrillation, n (%) | 6 (13.64%) | 14 (16.47%) | 0.68 |
Myocardial infarction, n (%) | 11 (25%) | 13 (15.29%) | 0.18 |
Previous PTCA, n (%) | 8 (18.18%) | 11 (12.94%) | 0.43 |
Previous CABG, n (%) | 5 (11.36%) | 1 (1.18%) | 0.01 |
Time from vaccination to COVID-19, days | 257 (201.5–294.5) |
Study Group (n = 44) | Control Group (n = 85) | p | |
---|---|---|---|
Coronarography, n (%) | 43 (97.73%) | 82 (96.47%) | 0.70 |
Optimal medical therapy, n (%) | 1 (2.27%) | 3 (3.53%) | 0.70 |
Coronary artery bypass grafting qualified, n (%) | 6 (13.64%) | 3 (3.53%) | 0.03 |
Percutaneous transluminal coronary angioplasty, n (%) | 32 (72.73%) | 73 (85.88%) | 0.07 |
Reached TIMI 3, n (%) | 30 (93.75%) | 62 (84.93%) | 0.15 |
Multivessel coronary artery disease, n (%) | 16 (36.36%) | 15 (17.65%) | 0.02 |
Left main coronary artery, n (%) | 1 (2.27%) | 2 (2.35%) | 0.73 |
Left anterior descending artery, n (%) | 13 (29.55%) | 25 (29.41%) | 0.99 |
Diagonal branches, n (%) | 3 (6.82%) | 2 (2.35%) | 0.21 |
Circumflex artery, n (%) | 4 (9.09%) | 7 (8.24%) | 0.87 |
Obtuse marginal artery, n (%) | 2 (4.55%) | 3 (3.53%) | 0.78 |
Right coronary artery, n (%) | 7 (15.91%) | 21 (24.71%) | 0.25 |
Posterior descending artery, n (%) | 0 (0%) | 0 (0%) | |
Intermediate artery, n (%) | 0 (0%) | 1 (1.18%) | 0.47 |
Bridge, n (%) | 1 (2.27%) | 1 (1.18%) | 0.64 |
Stent length, mm | 32.5 (23.25–57.5) | 32 (21.5–48) | 0.45 |
Staged revascularization *, n (%) | 4 (9.09%) | 1 (1.18%) | 0.03 |
Study Group (n = 44) | Control Group (n = 85) | p | |
---|---|---|---|
Cardiogenic shock, n (%) | 3 (6.82%) | 11 (12.94%) | 0.32 |
Pulmonary edema, n (%) | 5 (11.36%) | 5 (5.88%) | 0.30 * |
Respiratory failure, n (%) | 0 (0%) | 14 (16.47%) | 0.02 * |
Contrast-induced nephropathy, n (%) | 3 (6.82%) | 11 (12.94%) | 0.29 |
Stroke, n (%) | 0 (0%) | 0 (0%) | |
Bleeding requiring transfusion, n (%) | 0 (0%) | 4 (4.71%) | 0.30 * |
Hospitalization time (days) | 10.67 ± 8.78 | 9.13 ± 5.62 | 0.29 |
Univariable Cox Regression | Multivariable Cox Regression | |||||||
---|---|---|---|---|---|---|---|---|
Parameter | HR | −95% CI | +95% CI | p | HR | −95% CI | +95% CI | p |
Vaccination | 0.11 | 0.01 | 0.86 | 0.036 | 0.10 | 0.01 | 0.77 | 0.026 |
Sex | 1.33 | 0.48 | 3.71 | 0.584 | ||||
Diabetes | 2.39 | 0.99 | 5.78 | 0.052 | 2.76 | 1.14 | 6.66 | 0.024 |
GFR, mL/min | 0.98 | 0.97 | 1.00 | 0.101 | ||||
EF, % | 0.96 | 0.91 | 1.00 | 0.063 | ||||
Age, years | 1.02 | 0.99 | 1.06 | 0.206 | ||||
MI type (STEMI vs. NSTEMI) | 0.76 | 0.30 | 1.09 | 0.56 | ||||
Year of pandemic (1–3) | 0.58 | 0.28 | 1.18 | 0.12 |
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Hrycek, E.; Walawska-Hrycek, A.; Milewski, K.; Nowakowski, P.; Buszman, P.; Żurakowski, A. The Influence of SARS-CoV-2 Vaccination on the Mortality and Outcomes of Patients with Both Myocardial Infarction and COVID-19. Vaccines 2024, 12, 983. https://doi.org/10.3390/vaccines12090983
Hrycek E, Walawska-Hrycek A, Milewski K, Nowakowski P, Buszman P, Żurakowski A. The Influence of SARS-CoV-2 Vaccination on the Mortality and Outcomes of Patients with Both Myocardial Infarction and COVID-19. Vaccines. 2024; 12(9):983. https://doi.org/10.3390/vaccines12090983
Chicago/Turabian StyleHrycek, Eugeniusz, Anna Walawska-Hrycek, Krzysztof Milewski, Przemysław Nowakowski, Piotr Buszman, and Aleksander Żurakowski. 2024. "The Influence of SARS-CoV-2 Vaccination on the Mortality and Outcomes of Patients with Both Myocardial Infarction and COVID-19" Vaccines 12, no. 9: 983. https://doi.org/10.3390/vaccines12090983