Sex-specific differences in myocardial injury incidence after COVID-19 mRNA-1273 booster vaccination
© 2023 The Authors. European Journal of Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology..
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.
| Errataetall: |
CommentIn: Eur J Heart Fail. 2023 Oct;25(10):1882-1883. - PMID 37642187 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:25 |
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| Enthalten in: |
European journal of heart failure - 25(2023), 10 vom: 08. Okt., Seite 1871-1881 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Buergin, Natacha [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 01.11.2023 Date Revised 01.11.2023 published: Print-Electronic CommentIn: Eur J Heart Fail. 2023 Oct;25(10):1882-1883. - PMID 37642187 Citation Status MEDLINE |
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| doi: |
10.1002/ejhf.2978 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM359705626 |
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| 100 | 1 | |a Buergin, Natacha |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Sex-specific differences in myocardial injury incidence after COVID-19 mRNA-1273 booster vaccination |
| 264 | 1 | |c 2023 | |
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| 500 | |a Date Completed 01.11.2023 | ||
| 500 | |a Date Revised 01.11.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a CommentIn: Eur J Heart Fail. 2023 Oct;25(10):1882-1883. - PMID 37642187 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023 The Authors. European Journal of Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology. | ||
| 520 | |a AIMS: To explore the incidence and potential mechanisms of oligosymptomatic myocardial injury following COVID-19 mRNA booster vaccination | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a COVID-19 booster vaccination | |
| 650 | 4 | |a Cardiac troponin | |
| 650 | 4 | |a Myocardial injury | |
| 650 | 4 | |a Myocarditis | |
| 650 | 4 | |a mRNA vaccine | |
| 650 | 7 | |a 2019-nCoV Vaccine mRNA-1273 |2 NLM | |
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| 650 | 7 | |a Granulocyte-Macrophage Colony-Stimulating Factor |2 NLM | |
| 650 | 7 | |a 83869-56-1 |2 NLM | |
| 700 | 1 | |a Lopez-Ayala, Pedro |e verfasserin |4 aut | |
| 700 | 1 | |a Hirsiger, Julia R |e verfasserin |4 aut | |
| 700 | 1 | |a Mueller, Philip |e verfasserin |4 aut | |
| 700 | 1 | |a Median, Daniela |e verfasserin |4 aut | |
| 700 | 1 | |a Glarner, Noemi |e verfasserin |4 aut | |
| 700 | 1 | |a Rumora, Klara |e verfasserin |4 aut | |
| 700 | 1 | |a Herrmann, Timon |e verfasserin |4 aut | |
| 700 | 1 | |a Koechlin, Luca |e verfasserin |4 aut | |
| 700 | 1 | |a Haaf, Philip |e verfasserin |4 aut | |
| 700 | 1 | |a Rentsch, Katharina |e verfasserin |4 aut | |
| 700 | 1 | |a Battegay, Manuel |e verfasserin |4 aut | |
| 700 | 1 | |a Banderet, Florian |e verfasserin |4 aut | |
| 700 | 1 | |a Berger, Christoph T |e verfasserin |4 aut | |
| 700 | 1 | |a Mueller, Christian |e verfasserin |4 aut | |
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