Turkiye Klinikleri Cardiovascular Sciences

.: ORIGINAL RESEARCH
Potential Protective Effect of COVID-19 Vaccination Against Coronary Stent Thrombosis: Insights from a Retrospective Study in Türkiye
Koroner Stent Trombozuna Karşı COVID-19 Aşılamasının Potansiyel Koruyucu Etkisi: Türkiye'de Yapılan Retrospektif Bir Çalışmadan Elde Edilen Bulgular
Özlem ÖZBEKa , Mehmet Mustafa CANa
aHaseki Training and Research Hospital, Clinic of Cardiology, İstanbul, Türkiye
Turkiye Klinikleri J Cardiovasc Sci. 2024;36(2):47-56
doi: 10.5336/cardiosci.2024-106478
Article Language: EN
Full Text
ABSTRACT
 Objective: The aim of this study was to investigate the association between coronavirus disease-2019 (COVID-19) vaccination and stent thrombosis in patients with coronary stents. Material and Methods: This was a retrospective study conducted between January 2021 and December 2022. The study included patients with existing coronary stents who underwent coronary angiography for suspicion of stent thrombosis. A broad range of clinical data, including COVID-19 related data (disease history, number and brand of COVID19 vaccinations), laboratory findings, follow-up time, and mortality data were obtained retrospectively. The endpoints of the study were coronary stent thrombosis and all-cause mortality. Results: A total of 969 patients were included in the study. Stent thrombosis was present in 538 patients (55.52%), who were significantly younger and had a higher proportion of males compared to those without stent thrombosis. Multivariable logistic regression revealed active smoking, hypertension, diabetes mellitus, and coronary artery bypass graft+stent history as being independently associated with higher risk for stent thrombosis. Whereas, anticoagulant use and receiving 4 or more vaccine doses were independently associated with lower likelihood of stent thrombosis. Diabetes mellitus, previous cerebrovascular disease, high urea, and stent thrombosis were independently associated with mortality; whereas hyperlipidemia and receiving the BioNTech vaccine were independently associated with lower risk for mortality. Conclusion: Receiving multiple COVID-19 vaccine doses (regardless of type) may reduce the likelihood of stent thrombosis, possibly by protecting against COVID-19. However, more research is needed to understand the potential pathophysiological links between COVID-19 vaccination and coronary stent thrombosis.

Keywords: Coronavirus disease-2019; vaccines; coronary artery disease; stent thrombosis
ÖZET
 Amaç: Bu çalışmanın amacı, koroner stentli hastalarda koronavirüs hastalığı-2019 [coronavirus disease-2019 (COVID-19)] aşılaması ile stent trombozu arasındaki ilişkiyi araştırmaktır. Gereç ve Yöntemler: Bu çalışma, Ocak 2021 ile Aralık 2022 tarihleri arasında yürütülen retrospektif bir çalışmadır. Çalışmaya, stent trombozu şüphesiyle koroner anjiyografi yapılan mevcut koroner stentli hastalar dâhil edildi. COVID-19 ile ilgili veriler (hastalık öyküsü, COVID-19 aşılarının sayısı ve markası), laboratuvar bulguları, takip süresi ve mortalite verileri dâhil olmak üzere geniş bir klinik veri retrospektif olarak elde edildi. Çalışmanın sonlanım noktaları, koroner stent trombozu ve tüm nedenlere bağlı mortalite idi. Bulgular: Çalışmaya toplam 969 hasta dâhil edildi. Stent trombozu 538 hastada (%55,52) mevcuttu ve bu hastalar stent trombozu olmayanlara kıyasla anlamlı derecede daha gençti ve erkek oranı daha yüksekti. Çok değişkenli lojistik regresyon aktif sigara kullanımı, hipertansiyon, diyabetes mellitus ve koroner arter bypass greft+stent öyküsünün stent trombozu için daha yüksek risk ile bağımsız olarak ilişkili olduğunu ortaya koymuştur. Antikoagülan kullanımı ve 4 veya daha fazla aşı dozu alınması ise stent trombozu olasılığının daha düşük olmasıyla bağımsız olarak ilişkilendirilmiştir. Diyabetes mellitus, geçirilmiş serebrovasküler hastalık, yüksek üre ve stent trombozu bağımsız olarak mortalite ile ilişkiliyken; hiperlipidemi ve BioNTech aşısı olmak bağımsız olarak daha düşük mortalite riski ile ilişkiliydi. Sonuç: Birden fazla COVID-19 aşısı dozu almak (tipine bakılmaksızın), muhtemelen COVID-19'a karşı koruma sağlayarak stent trombozu olasılığını azaltabilir. Bununla birlikte, COVID-19 aşılaması ile koroner stent trombozu arasındaki potansiyel patofizyolojik bağlantıları anlamak için daha fazla araştırmaya ihtiyaç vardır.

Anahtar Kelimeler: Koronavirüs hastalığı-2019; aşılar; koroner arter hastalığı; stent trombozu
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