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In Silico Clinical Trials for Cardiovascular Disease
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COVID-19 Vaccination and Cardiovascular Events: A Systematic Review and Bayesian Multivariate Meta-Analysis of

Raheleh Karimi1,2, Mina Norozirad3, Foad Esmaeili4

  • 1Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran.

International Journal of Preventive Medicine
|April 7, 2025
PubMed

Insights

COVID-19 vaccination was linked to an increased risk of coronary artery disease (CAD), especially after the second dose of BNT162b2. However, the third vaccine dose showed a protective effect against stroke and myocardial infarction.

Area of Science:

  • Cardiology
  • Immunology
  • Public Health

Background:

  • Investigating the association between COVID-19 vaccination and cardiovascular events is crucial for public health.
  • A comprehensive strategy is needed to understand potential risks and benefits.
  • Cardiovascular events include myocardial infarction, stroke, arrhythmia, and coronary artery disease (CAD).

Purpose of the Study:

  • To examine the association between COVID-19 vaccination and cardiovascular events.
  • To apply a comprehensive strategy for understanding vaccine-related cardiovascular risks.
  • To analyze data across multiple cardiovascular outcomes.

Main Methods:

  • A Bayesian multivariate meta-analysis was conducted using summary data from fifteen studies.
  • Eleven studies compared vaccinated and unvaccinated groups.
  • Six studies specifically compared mRNA COVID-19 vaccines (Pfizer-BioNTech and Moderna).

Main Results:

  • A link was found between COVID-19 vaccination and increased CAD risk (OR, 1.70), particularly after the BNT162b2 vaccine's second dose (OR, 3.44).
  • No increased risk of heart attack, arrhythmia, or stroke was observed following vaccination.
  • The third vaccine dose demonstrated a protective effect against stroke (OR, 0.19) and myocardial infarction (OR, 0.003).

Conclusions:

  • COVID-19 vaccination is associated with an increased risk of coronary artery disease, particularly with the BNT162b2 vaccine.
  • The third vaccine dose may offer protective cardiovascular benefits.
  • Future vaccine technologies should consider the association with coronary artery disease risk.
Abstract

Keywords:
ArrhythmiasCOVID-19 vaccinesSARS-CoV-2cardiaccoronary artery diseasemyocardial infarctionstroke

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