SARS-CoV-2 mRNA vaccines ‘safe to use in heart failure patients’
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SARS-CoV-2 vaccination with mRNA vaccines was found to be safe in a large cohort of Danish patients with HF and in turn reduced risk for all-cause death, according to a poster presented at the European Society of Cardiology Congress.
“Patients with heart failure represent a patient population that are extraordinarily vulnerable to SARS-CoV-2 infection. In the absence of effective treatment, vaccines are the best prevention for morbidity and mortality in this patient population; however, some concerns remain about the mRNA vaccines in these patients due to a perceived increased risk of cardiovascular side effects,” Caroline Sindet-Pedersen, MD, postdoctoral researcher of Herlev and Gentofe Hospital, in Hellerup, Denmark, said during a presentation. “I have conducted a nationwide, register-based study which found that among 100,000 heart failure patients, receiving a mRNA vaccine was not associated with an increased risk of worsening heart failure, myocarditis or venous thromboembolism, but was associated with a decreased risk of all-cause mortality.”
To assess the risk for worsening HF and all-cause mortality related to SARS-CoV-2 mRNA vaccination, researchers utilized a Danish nationwide registry to identify two unique populations: all patients with HF in 2019; and all patients with HF in 2021 who received either the BNT162B2 (BioNTech/Pfizer) or mRNA-1273 (Moderna) vaccines.
The primary endpoints were all-cause death, worsening HF, venous thromboembolism and myocarditis.
Patients in the two cohorts were matched 1:1 based on age, sex and HF duration (median age, 74 years; 64% men).
Patients were followed up for 90 days, until a first event or until the study ended on Sept. 30, 2021, whichever came first.
Among vaccinated patients, 92% received the BNT162B2 vaccine.
Compared with their unvaccinated counterparts, there was no significant difference in risk among vaccinated patients with HF for:
- worsening HF (absolute difference, 0.02%; 95% CI, –0.11 to 0.15);
- myocarditis (absolute difference, 0.01; 95% CI, 0-0.02); or
- venous thromboembolism (absolute difference, –0.02; 95% CI, –0.05 to 0.01).
Moreover, the researchers reported a lower absolute risk for all-cause death among vaccinated patients with HF compared with pre-pandemic unvaccinated patients (–0.033%; 95% CI, –0.52 to –0.15).
“Among 100,000 heart failure patients, we found that receiving a mRNA vaccine was not associated with an increased risk of worsening heart failure, myocarditis or venous thromboembolism, but was associated with a decreased risk of all-cause mortality, suggesting that the vaccines are safe to use in heart failure patients,” Sindet-Pedersen said during the presentation.
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Sindet-Pedersen C, et al. COVID-19 and heart failure. Presented at: European Society of Cardiology Congress; Aug. 26-29, 2022; Barcelona, Spain (hybrid meeting).
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