COVID-19 mRNA-1273 booster vaccination resulted in a 2.8% incidence of mild, transient myocardial injury, occurring more frequently in women (3.7%) than men (0.8%).
Observational (n=1,554)
Does COVID-19 mRNA-1273 booster vaccination cause myocardial injury in hospital employees?
mRNA-1273 booster vaccination is associated with a 2.8% incidence of mild, transient myocardial injury, which is more frequent in women than men but not associated with short-term major adverse cardiac events.
AIMS: To explore the incidence and potential mechanisms of oligosymptomatic myocardial injury following COVID-19 mRNA booster vaccination. METHODS AND RESULTS: Hospital employees scheduled to undergo mRNA-1273 booster vaccination were assessed for mRNA-1273 vaccination-associated myocardial injury, defined as acute dynamic increase in high-sensitivity cardiac troponin T (hs-cTnT) concentration above the sex-specific upper limit of normal on day 3 (48-96 h) after vaccination without evidence of an alternative cause. To explore possible mechanisms, antibodies against interleukin-1 receptor antagonist (IL-1RA), the SARS-CoV-2-nucleoprotein (NP) and -spike (S1) proteins and an array of 14 inflammatory cytokines were quantified. Among 777 participants (median age 37 years, 69.5% women), 40 participants (5.1%; 95% confidence interval CI 3.7-7.0%) had elevated hs-cTnT concentration on day 3 and mRNA-1273 vaccine-associated myocardial injury was adjudicated in 22 participants (2.8% 95% CI 1.7-4.3%). Twenty cases occurred in women (3.7% 95% CI 2.3-5.7%), two in men (0.8% 95% CI 0.1-3.0%). Hs-cTnT elevations were mild and only temporary. No patient had electrocardiographic changes, and none developed major adverse cardiac events within 30 days (0% 95% CI 0-0.4%). In the overall booster cohort, hs-cTnT concentrations (day 3; median 5, interquartile range IQR 4-6 ng/L) were significantly higher compared to matched controls (n = 777, median 3 IQR 3-5 ng/L, p < 0.001). Cases had comparable systemic reactogenicity, concentrations of anti-IL-1RA, anti-NP, anti-S1, and markers quantifying systemic inflammation, but lower concentrations of interferon (IFN)-λ1 (IL-29) and granulocyte-macrophage colony-stimulating factor (GM-CSF) versus persons without vaccine-associated myocardial injury. CONCLUSION: mRNA-1273 vaccine-associated myocardial injury was more common than previously thought, being mild and transient, and more frequent in women versus men. The possible protective role of IFN-λ1 (IL-29) and GM-CSF warrant further studies.
Buergin et al. (Thu,) conducted a observational in Myocardial injury following COVID-19 mRNA booster vaccination (n=1,554). COVID-19 mRNA-1273 booster vaccination vs. Matched controls was evaluated on mRNA-1273 vaccine-associated myocardial injury (95% CI 1.7-4.3). COVID-19 mRNA-1273 booster vaccination resulted in a 2.8% incidence of mild, transient myocardial injury, occurring more frequently in women (3.7%) than men (0.8%).
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