Cardiovascular events following coronavirus disease 2019 vaccination in adults: a nationwide Swedish study.

Eur Heart J

School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, BOX 414, 40 530 Gothenburg, Sweden.

Published: January 2025

AI Article Synopsis

  • The study investigates the cardiovascular effects of COVID-19 mRNA vaccination in over 8 million Swedish adults, focusing on risks for myocarditis, pericarditis, dysrhythmias, heart failure, myocardial infarction, and cerebrovascular events.
  • Results indicate that while there is a temporary increase in risks for myocarditis and extrasystoles shortly after vaccination, overall cardiovascular risks significantly decrease after full vaccination, particularly after the third dose.
  • The findings highlight the importance of vaccination in reducing severe cardiovascular complications associated with COVID-19, validating its protective benefits despite some rare adverse events.

Article Abstract

Background And Aims: While the rationale for coronavirus disease 2019 (COVID-19) vaccination is to reduce complications and overall mortality, some cardiovascular complications from the vaccine itself have been demonstrated. Myocarditis and pericarditis are recognized as rare acute adverse events after mRNA vaccines in young males, while evidence regarding other cardiovascular events remains limited and inconsistent. This study assessed the risks of several cardiovascular and cerebrovascular events in a Swedish nationwide register-based cohort.

Methods: Post-vaccination risk of myocarditis/pericarditis, dysrhythmias, heart failure, myocardial infarction, and cerebrovascular events (transient ischaemic attack and stroke) in several risk windows after each vaccine dose were assessed among all Swedish adults (n = 8 070 674). Hazard ratios (HRs) with 95% confidence intervals (95% CIs) compared with unvaccinated were estimated from Cox regression models adjusted for potential confounders.

Results: For most studied outcomes, decreased risks of cardiovascular events post-vaccination were observed, especially after dose three (HRs for dose three ranging from .69 to .81), while replicating the increased risk of myocarditis and pericarditis 1-2 weeks after COVID-19 mRNA vaccination. Slightly increased risks, similar across vaccines, were observed for extrasystoles [HR 1.17 (95% CI 1.06-1.28) for dose one and HR 1.22 (95% CI 1.10-1.36) for dose two, stronger in elderly and males] but not for arrhythmias and for transient ischaemic attack [HR 1.13 (95% CI 1.05-1.23), mainly in elderly] but not for stroke.

Conclusions: Risk of myopericarditis (mRNA vaccines only), extrasystoles, and transient ischaemic attack was transiently increased after COVID-19 vaccination, but full vaccination substantially reduced the risk of several more severe COVID-19-associated cardiovascular outcomes, underscoring the protective benefits of complete vaccination.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11704415PMC
http://dx.doi.org/10.1093/eurheartj/ehae639DOI Listing

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