Covid mRNA vaccines safe in patients with heart failure, shows study

Covid mRNA vaccines are associated with a decreased risk of death in patients with heart failure, says a new study.

The study, presented at ESC Congress 2022, found that the vaccines were not associated with an increased risk of worsening heart failure, venous thromboembolism or myocarditis in heart failure patients.

"Our results indicate that heart failure patients should be prioritised for Covid-19 vaccinations and boosters," said study author Caroline Sindet-Pedersen of Herlev and Gentofe Hospital, Hellerup, Denmark.

For the study, the team included 50,893 unvaccinated patients with heart failure in 2019 and 50,893 patients with heart failure in 2021 who were vaccinated with either of the two mRNA vaccines (BNT162B2 or mRNA-1273).

The two groups were matched for age, sex, and duration of heart failure. The median age of participants was 74 years and 35 per cent were women and the median duration of heart failure was 4.1 years.

Participants were followed for 90 days for all-cause mortality, worsening heart failure, venous thromboembolism, and myocarditis, starting from the date of the second vaccination for the 2021 group and the same date in 2019 for the unvaccinated group.

The researchers compared the risk of adverse outcomes in the two groups, after standardising for age, sex, heart failure duration, use of heart failure medications, ischaemic heart disease, cancer, diabetes, atrial fibrillation, and admission with heart failure less than 90 days before the first date of follow up.

Among 101,786 heart failure patients, the researchers found that receiving an 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.

The standardised risk of all-cause mortality within 90 days was 2.2 per cent in the 2021 cohort (vaccinated) and 2.6 per cent in the 2019 cohort (not vaccinated), showing a significantly lower risk for all-cause mortality in 2021 versus 2019.

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