Cardiovascular Disease and COVID-19 Vaccines: A Systematic Review and Analysis of Published Cases

COVID-19 Vaccination and Cardiovascular Events: A Systematic Review and Bayesian Multivariate Meta-Analysis of Preventive Benefits and Risks

Background

To provide a detailed understanding and apply a comprehensive strategy, this study examines the association between COVID-19 vaccination and cardiovascular events. We conducted a Bayesian multivariate meta-analysis using summary data across multiple outcomes including myocardial infarction, stroke, arrhythmia, and CAD, considering potential dependencies in the data. Markov chain Monte Carlo (MCMC) methods were detected for easy implementation of the Bayesian approach. Also, the sensitivity analysis of the model was done by using different priors.

Methods

Fifteen studies were included in the systematic review, with eleven studies comparing the results between the vaccine group and the unvaccinated group. Additionally, six studies were used for further analysis to compare mRNA COVID-19 Vaccines (Pfizer-BioNTech and Moderna).

Results

Bayesian meta-analysis revealed a link between vaccines and CAD risk (OR, 1.70; 95% CrI: 1.11-2.57), particularly after BNT162b2 (OR, 1.64; 95% CrI: 1.06-2.55) and second dose (OR, 3.44; 95% CrI: 1.99-5.98). No increased risk of heart attack, arrhythmia, or stroke was observed post-COVID-19 vaccination. As the only noteworthy point, a protective effect on stroke (OR, 0.19; 95% CrI: 0.10-0.39) and myocardial infarction (OR, 0.003; 95% CrI: 0.001-0.006) was observed after the third dose of the vaccine.

Conclusions

Secondary analysis showed no notable disparity in cardiovascular outcomes between BNT162b2 and mRNA vaccines. The association of COVID-19 vaccination with the risk of coronary artery disease should be considered in future vaccine technologies for the next pandemic.

HLA binding-groove motifs are associated with myocarditis induction after Pfizer-BioNTech BNT162b2 vaccination

BACKGROUND AND AIMS

We found a higher incidence of myocarditis in young males who had received at least two Pfizer-BioNTech BNT162b2 vaccinations. The human leukocyte antigens (HLA) are known to play an important role in infectious and autoinflammatory diseases. We hypothesized that certain HLA alleles might be associated with vaccination-induced myocarditis.

METHODS

HLA typing was performed using next-generation sequencing technology with the Illumina Iseq100 platform. HLA class I and II loci were genotyped in 29 patients with post-vaccination myocarditis and compared with HLA data from 300 healthy controls.

RESULTS

We demonstrate that the DRB1*14:01, DRB1*15:03 alleles and the motifs in HLA-A - Leu62 and Gln63, which are part of binding pocket B and HLA-DR Tyr47, His60, Arg70 and Glu74, which are part of binding pockets P4, P7 and P9, were significantly associated with disease susceptibility.

CONCLUSIONS

Our findings suggest that immunogenetic fingerprints in HLA peptide-binding grooves may affect the presentation of peptides derived from the Pfizer-BioNTech BNT162b2 vaccination to T cells and induce an inflammatory process that results in myocarditis.