Patients With ST-Segment Elevation Myocardial Infarction and Cerebrovascular Accidents: Impact of COVID-19 Vaccination on Mortality.

IF 1.4 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiology Research Pub Date : 2024-08-01 Epub Date: 2024-08-20 DOI:10.14740/cr1688

Sharvil Patel, Mahmoud Ballout, Sandus Khan, Shane Robinson, Alex M Adams, Ania Rynarzewska, John E Delzell

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引用次数: 0

Abstract

Background: Coronavirus disease 2019 (COVID-19) infection is associated with proinflammatory states and adverse health outcomes such as ST-segment elevation myocardial infarction (STEMI) and cerebrovascular accidents (CVA). Limited evidence suggests that COVID-19 vaccination may decrease the adverse impact of COVID-19 infections. This study was designed to determine if patients who received COVID-19 vaccination had lower mortality from STEMI and CVA.

Methods: This is a retrospective comparative analysis of 3,050 patients, who were admitted to the hospital and diagnosed with STEMI or CVA between April 1, 2019, and April 1, 2022. Patients were divided into three different timeframes: pre-COVID (April 1, 2019, to March 31, 2020), COVID (April 1, 2020 to March 31, 2021), and post-COVID (April 1, 2021 to March 31, 2022). Chi-square analysis was completed to analyze associations between STEMI, CVA, and vaccination status. A multinominal logistic regression was used to determine significant predictors for in-hospital mortality.

Results: A total of 3,050 patients were admitted (1,873 STEMI and 1,177 CVA). STEMI accounted for about 60% of cases in each of the three time periods. There was no statistical difference in STEMI or CVA percentages in the three time periods. There was increased mortality in STEMI and CVA patients (odds ratio (OR) = 11.4; P < 0.001), but patients who received the COVID-19 vaccine were less likely to die (OR = 0.51, 95% confidence interval (CI): 0.28 - 0.93; P < 0.027) when compared to those who were unvaccinated. There was increased risk of death in patients with atrial fibrillation (AFIB) (OR = 2.43; P < 0.001) and chronic heart failure (CHF) (OR = 1.76; P = 0.004). There was increased mortality risk associated with age (OR =1.03; P = 0.001). Patients with coronary artery disease (CAD) (OR = 0.45; P = 0.014) and hyperlipidemia (OR = 0.29; P < 0.001) were less likely to die.

Conclusions: Vaccination against COVID-19 was associated with reduced mortality rates in patients hospitalized with STEMI and CVA. Patients with pre-existing cardiovascular comorbidities such as CAD and hyperlipidemia also had lower mortality.

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ST段抬高心肌梗死和脑血管意外患者：接种 COVID-19 疫苗对死亡率的影响。

背景：2019年冠状病毒病（COVID-19）感染与促炎症状态和不良健康后果有关，如ST段抬高型心肌梗死（STEMI）和脑血管意外（CVA）。有限的证据表明，接种 COVID-19 疫苗可降低 COVID-19 感染的不良影响。本研究旨在确定接种 COVID-19 疫苗的患者是否会降低 STEMI 和 CVA 的死亡率：本研究对 2019 年 4 月 1 日至 2022 年 4 月 1 日期间入院并被诊断为 STEMI 或 CVA 的 3050 名患者进行了回顾性比较分析。患者被分为三个不同的时间段：COVID 前（2019 年 4 月 1 日至 2020 年 3 月 31 日）、COVID（2020 年 4 月 1 日至 2021 年 3 月 31 日）和 COVID 后（2021 年 4 月 1 日至 2022 年 3 月 31 日）。为分析 STEMI、CVA 和疫苗接种状况之间的关联，我们进行了卡方分析。多项式逻辑回归用于确定院内死亡率的重要预测因素：共收治了 3,050 名患者（1,873 名 STEMI 和 1,177 名 CVA）。在这三个时间段中，STEMI 约占 60%。三个时间段的 STEMI 和 CVA 百分比没有统计学差异。STEMI 和 CVA 患者的死亡率增加（几率比 (OR) = 11.4；P < 0.001），但与未接种疫苗的患者相比，接种 COVID-19 疫苗的患者死亡的可能性较低（OR = 0.51，95% 置信区间 (CI)：0.28 - 0.93；P < 0.027）。心房颤动（AFIB）（OR = 2.43；P < 0.001）和慢性心力衰竭（CHF）（OR = 1.76；P = 0.004）患者的死亡风险增加。年龄越大，死亡风险越高（OR = 1.03；P = 0.001）。患有冠状动脉疾病（CAD）（OR = 0.45；P = 0.014）和高脂血症（OR = 0.29；P < 0.001）的患者死亡几率较低：结论：接种COVID-19疫苗可降低STEMI和CVA住院患者的死亡率。结论：接种COVID-19疫苗与降低STEMI和CVA住院患者的死亡率有关，原有心血管合并症（如CAD和高脂血症）的患者死亡率也较低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cardiology Research CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

2.50

自引率

0.00%

发文量

期刊介绍： Cardiology Research is an open access, peer-reviewed, international journal. All submissions relating to basic research and clinical practice of cardiology and cardiovascular medicine are in this journal''s scope. This journal focuses on publishing original research and observations in all cardiovascular medicine aspects. Manuscript types include original article, review, case report, short communication, book review, letter to the editor.