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December 11, 2025Journal of the American Heart Association3 citationsOpen Access

Adjudicated Cardiovascular Events in Patients With COVID‐19: Association With Vaccination Status and Changes over Time

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BBBehnood BikdeliDKDarsiya KrishnathasanABAntoine Bejjani

Key Points

  • This research aims to evaluate the association between vaccination status and cardiovascular events in COVID‐19 patients over time.
  • Multicenter registry study (CORONA‐VTE Network) from March 2020 to February 2024
  • Assessment of thrombotic and cardiovascular events at 90 days post COVID‐19 diagnosis
  • Time‐to‐first‐event analyses adjusted for competing risks.
  • Outcomes adjudicated by independent physicians.
  • Out of 11,165 patients, the 90-day cumulative incidence of cardiovascular events among inpatients was 15.6%.
  • In intensive care unit patients, the incidence of cardiovascular events was 30.7%.
  • Vaccination was associated with a reduced risk of cardiovascular events (adjusted HR, 0.75; P =0.005).
  • No significant linear change in cardiovascular events over time was observed.

Abstract

Background Patients with COVID‐19 are at risk of thrombotic and cardiovascular complications. Existing risk estimates derive from early COVID‐19 experiences. More recent event rates, temporal trends, and the association between vaccination status and cardiovascular outcomes remain unclear. Methods The CORONA‐VTE Network (COVID‐19 Registry to Assess Frequency, Risk Factors, Management, and Outcomes of Arterial and Venous Thromboembolic Complications) multicenter registry included patients with COVID‐19 from March 2020 to February 2024. A composite of venous and arterial thrombotic events and a composite of adjudicated cardiovascular events were assessed at 90 days after COVID‐19 diagnosis. Time‐to‐first‐event analyses were stratified by inpatients and outpatients and adjusted for competing risks. Outcomes were adjudicated by independent physicians. Results Of 11 165 patients, 4451 were inpatients (mean age, 65 years; 47% women) and 462 of 4451 were admitted to the intensive care unit. Among inpatients, the 90‐day cumulative incidences of thrombotic and cardiovascular events were 8.9% (95% CI, 8.0%–9.8%) and 15.6% (95% CI, 14.5%–16.7%), respectively. Corresponding estimates for patients in the intensive care unit were 20.0% (95% CI, 16.6%–24.0%) and 30.7% (95% CI, 26.8%–35.3%), while event rates were low among outpatients. There was an initial decline in cardiovascular events (adjusted hazard ratio HR, 0.84; P =0.001) after the first COVID‐19 wave, with a subsequent catch‐up, with no significant linear change in cardiovascular events (adjusted P trend =0.634). Vaccination was associated with a reduced risk of cardiovascular events (adjusted HR, 0.75 95% CI, 0.62–0.92; P =0.005). Conclusions Thrombotic and cardiovascular events are common in hospitalized patients with COVID‐19, especially those in the intensive care unit, without a persistent decline over time. COVID‐19 vaccination was associated with a reduced risk of cardiovascular events.

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Cite This Study

Bikdeli et al. (2025) studied this question.

synapsesocial.com/papers/694019342d562116f28f6fa0https://doi.org/10.1161/jaha.125.044011
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