According to a poster presentation at the European Society of Cardiology Congress 2022, COVID-19 mRNA vaccines are correlated with a diminished risk of death in patients HF, and the vaccines were not associated with an increased risk of worsening HF, venous thromboembolism, or myocarditis in HF patients.

During the presentation, Caroline Sindet-Pedersen, MD, postdoctoral researcher of Herlev and Gentofe Hospital in Hellerup, Denmark, stated, “Our results indicate that heart failure patients should be prioritized for COVID-19 vaccinations and boosters. COVID-19 vaccines will continue to be important for preventing morbidity and mortality in vulnerable patient populations. Thus, studies emphasizing the safety of these vaccines are essential to reassure those who might be hesitant and ensure continued uptake of vaccinations.”

Vaccination diminishes the risk of serious illness from COVID-19. However, Dr. Sindet-Pedersen stated, “Due to perceptions about possible cardiovascular side effects from mRNA vaccines in heart failure patients, this study examined the risk of cardiovascular complications and death associated with mRNA vaccines in a nationwide cohort of patients with heart failure.”

In the study, researchers evaluated the risk for worsening HF and all-cause mortality related to SARS-CoV-2 mRNA vaccination. The primary endpoints were all-cause death, worsening HF, venous thromboembolism, and myocarditis.

The study included 50,893 unvaccinated patients with HF in 2019 and 50,893 patients with HF in 2021 who were vaccinated with either of the two mRNA vaccines (BNT162B2 or mRNA-1273). The groups were matched for age, gender, and duration of HF. The average age of participants was 74 years, and 35% were women. The average duration of HF was 4.1 years. Participants were followed for 90 days for all-cause mortality, worsening HF, venous thromboembolism, and myocarditis, starting from the date of the second vaccination for the 2021 group and the same date in 2019 for the unvaccinated group.

The researchers compared the risk of adverse outcomes in the two groups after standardizing for age, gender, HF duration, use of HF medications, ischemic heart disease, cancer, diabetes, atrial fibrillation, and admission with HF fewer than 90 days before the first date of follow up. Dr. Sindet-Pedersen stated, “Standardization imitates a randomized trial and is a way to obtain a better causal interpretation of the results from observational studies.”

Among the 101,786 HF patients, the researchers discovered that receiving an mRNA vaccine was not correlated with an increased risk of worsening HF, myocarditis, or venous thromboembolism; however, it was correlated with a decreased risk of all-cause mortality. The standardized risk of all-cause mortality within 90 days was 2.2% in the 2021 cohort (vaccinated) and 2.6% in the 2019 cohort (not vaccinated), showing a substantially lower risk for all-cause mortality in 2021 versus 2019. The standardized risk of worsening HF within 90 days was 1.1% in both cohorts. Comparably, no significant differences were observed between groups for venous thromboembolism or myocarditis.

Dr. Sindet-Pedersen concluded, “The study suggests that there should be no concern about cardiovascular side effects from mRNA vaccines in heart failure patients. In addition, the results point to a beneficial effect of vaccination on mortality.”

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