International Journal of Cardiology Cardiovascular Risk and Prevention最新文献_第5页

Relationship between stroke onset timing and clinical outcomes in ischemic and hemorrhagic strokes: a systematic review 缺血性和出血性脑卒中发病时间与临床结局的关系：一项系统综述

IF 2.1 Q3 PERIPHERAL VASCULAR DISEASE

International Journal of Cardiology Cardiovascular Risk and Prevention

Pub Date : 2026-03-01 Epub Date: 2025-12-14 DOI: 10.1016/j.ijcrp.2025.200559

Paria Heidari , Negar Heidari , Habibolah Khazaie , Sabra Margaret Abbott , Azad Maroufi , Amir Abdolmaleki , Nader Salari , Masoud Mohammadi , Amir Sharafkhaneh

Background

Cerebrovascular accident (CVA) is a critical medical pathology caused by the interruption of cerebral blood flow and leads to neuronal injury or neurodegeneration. Generally, CVAs are classified into two primary categories of ischemic and hemorrhagic. Investigation of circadian rhythm variation at the time of CVA onset is a critical subject for patient management, clinical treatment, and further scientific research. This systematic review aimed to investigate the relationship between the timing of stroke onset and patient outcomes in both ischemic and hemorrhagic strokes.

Methods

Following searching strategy designation, international databases of Embase, PubMed, Scopus, WoS, ScienceDirect, and Google Scholar were searched using the MeSH-based keywords. No time restrictions were applied in this regard (by December 8, 2024). All English-based observational studies reporting the risk of CVA at various daytimes were enrolled for screenings and quality control. Finally, eligible studies were selected for data extraction and categorization.

Results

According to the reports, ischemic strokes strictly occur in morning hours (06:00 to 12:00) while some studies recorded a bimodal pattern (dual peaks during morning and evening). It was also established that the strokes at night were more severe and yielded more unfavorable results. Scattered reports were found regarding the hemorrhagic strokes; some papers revealed the highest incidence in the early morning hours, while others reported the late evening or nighttime occurrence. In addition, some studies showed that nighttime hemorrhagic strokes are usually associated with greater severity and unfavorable clinical outcomes.

Conclusion

This study clarified the effect of cyclic pattern on the incidence and outcome of stroke. These trends seem greatly accounted for improvement of prevention strategies, management of treatments, and enhancement of patient outcomes.

脑血管意外（cerebrovascular accident， CVA）是由脑血流中断引起的一种重要的医学病理，可导致神经元损伤或神经变性。一般来说，cva分为缺血性和出血性两大类。研究CVA发病时的昼夜节律变化对患者管理、临床治疗和进一步的科学研究至关重要。本系统综述旨在探讨缺血性和出血性卒中患者卒中发病时间与预后之间的关系。方法采用基于mesh的关键词对Embase、PubMed、Scopus、WoS、ScienceDirect、b谷歌Scholar等国际数据库进行检索。在这方面没有时间限制（到2024年12月8日）。所有以英语为基础的观察性研究均报告了不同白天发生CVA的风险，并纳入了筛查和质量控制。最后，选择符合条件的研究进行数据提取和分类。结果缺血性脑卒中主要发生在早晨（06:00 - 12:00），也有研究记录了双峰模式（早晚双峰）。研究还发现，夜间中风更严重，产生的不良后果也更多。有关出血性中风的零星报道；一些论文揭示了清晨的发病率最高，而另一些则报道了深夜或夜间的发病率。此外，一些研究表明，夜间出血性中风通常与更严重和不利的临床结果相关。结论本研究明确了循环模式对脑卒中发病率和转归的影响。这些趋势似乎在很大程度上说明了预防策略的改进、治疗的管理和患者预后的提高。

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引用次数: 0

From analysis to action: Confronting regional IHD mortality inequities 从分析到行动：应对区域IHD死亡率不平等

IF 2.1 Q3 PERIPHERAL VASCULAR DISEASE

International Journal of Cardiology Cardiovascular Risk and Prevention

Pub Date : 2025-12-01 Epub Date: 2025-07-30 DOI: 10.1016/j.ijcrp.2025.200478

Jonathan James O. Canete

This correspondence paper engages critically with the study titled “Three-decade analysis of regional disparities in metabolic risk factor related ischemic heart disease mortality: Contrasting trends between South Asia and North America.” The study presents a comprehensive long-term analysis of ischemic heart disease (IHD) mortality trends, revealing increasing mortality rates in South Asia despite similar metabolic risk factor burdens compared to declining rates in North America. While commendable in its scope and rigor, the study could have explored additional social determinants of health, including socioeconomic inequality, education, and healthcare accessibility, to better explain regional disparities. Furthermore, the reliance on aggregated data without stratification by gender, socioeconomic status, or urban-rural differences limits the study's applicability for developing targeted interventions. This correspondence advocates for integrating these factors into future analyses and calls for actionable, regionally tailored policy recommendations to address IHD mortality inequities. Overall, the paper underscores the need for equity-focused strategies that translate epidemiological insights into effective and contextually relevant public health interventions.

这篇通信论文对题为“代谢危险因素相关缺血性心脏病死亡率区域差异的三十年分析：南亚和北美之间的对比趋势”的研究进行了批判性的探讨。该研究对缺血性心脏病（IHD）死亡率趋势进行了全面的长期分析，揭示了尽管代谢风险因素负担相似，但南亚的死亡率仍在上升，而北美的死亡率则在下降。虽然这项研究的范围和严密性值得称赞，但它本可以探索健康的其他社会决定因素，包括社会经济不平等、教育和医疗保健可及性，以更好地解释地区差异。此外，对汇总数据的依赖，没有按性别、社会经济地位或城乡差异分层，限制了该研究在制定有针对性干预措施方面的适用性。这一信函主张将这些因素纳入未来的分析，并呼吁提出可行的、适合区域的政策建议，以解决IHD死亡率不平等问题。总体而言，该文件强调需要采取以公平为重点的战略，将流行病学见解转化为有效和与具体情况相关的公共卫生干预措施。

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引用次数: 0

Heart failure care in low-middle income countries: Time for incorporating gender-specific guidelines? 中低收入国家的心力衰竭护理：是时候纳入针对性别的指南了？

IF 2.1 Q3 PERIPHERAL VASCULAR DISEASE

International Journal of Cardiology Cardiovascular Risk and Prevention

Pub Date : 2025-12-01 Epub Date: 2025-09-01 DOI: 10.1016/j.ijcrp.2025.200508

P.B. Jayagopal

引用次数: 0

Shared genetic associations between CHA2DS2-VASc score and cardio-embolic stroke: Insights from mendelian randomization based bioinformatics analysis CHA2DS2-VASc评分与心脏栓塞性中风之间的共同遗传关联：孟德尔随机化生物信息学分析的见解

IF 2.1 Q3 PERIPHERAL VASCULAR DISEASE

International Journal of Cardiology Cardiovascular Risk and Prevention

Pub Date : 2025-12-01 Epub Date: 2025-09-10 DOI: 10.1016/j.ijcrp.2025.200514

Kang Yuan , Xianshu Huo , Mengdi Xie , Huaiming Wang , Siyu Sun , Kejia Deng , Rui Liu , Xinfeng Liu

The CHA₂DS₂-VASc score is a risk assessment score to predict cardio-embolic stroke (CES), suggesting shared genetic susceptibility. This study aimed to explore the shared genetic association of genetically predicted CHA₂DS₂-VASc score and CES using multiple analytic frameworks. We conducted a comprehensive analysis of genetic data from 13 traits of CHA₂DS₂-VASc score and CES using summary statistics from large-scale genome-wide association studies (GWAS). We employed statistical methods such as linkage disequilibrium score regression (LDSC), cross-trait analysis, bidirectional Mendelian randomization, colocalization analysis and gene-based association analysis to explore genetic correlations and identify pleiotropic single nucleotide polymorphisms (SNPs) and shared genes. LDSC and Mendelian randomization analysis revealed a significant genetic correlation between CHA₂DS₂-VASc score and CES. Cross-trait and colocalization analysis identified 9 potential loci and 13 significant independent SNPs. Gene-based association analysis reported 9 genes significant across at least three methods, with IL6R being the shared gene identified by all four methods, highlighting potential shared biological mechanisms involving immune responses and inflammatory activities. In conclusion, our study revealed shared genetic associations between the genetically predicted CHA₂DS₂-VASc score and CES, which was supported by causal relationship, shared loci, and genetic correlation analyses.

CHA2DS2-VASc评分是预测心源性卒中（CES）的风险评估评分，提示有共同的遗传易感性。本研究旨在通过多种分析框架探讨遗传预测CHA2DS2-VASc评分与CES之间的共同遗传关联。我们利用大规模全基因组关联研究（GWAS）的汇总统计数据，对CHA2DS2-VASc评分和CES的13个性状的遗传数据进行了综合分析。采用连锁不平衡评分回归（LDSC）、交叉性状分析、双向孟德尔随机化、共定位分析和基于基因的关联分析等统计方法探讨遗传相关性，鉴定多效单核苷酸多态性（snp）和共享基因。LDSC和孟德尔随机化分析显示，CHA2DS2-VASc评分与CES具有显著的遗传相关性。交叉性状和共定位分析鉴定出9个潜在位点和13个显著的独立snp。基于基因的关联分析报告了9个基因在至少三种方法中具有显著性，其中IL6R是所有四种方法鉴定的共享基因，突出了涉及免疫反应和炎症活动的潜在共享生物学机制。总之，我们的研究揭示了基因预测的CHA2DS2-VASc评分与CES之间存在共同的遗传关联，这得到了因果关系、共享位点和遗传相关分析的支持。

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引用次数: 0

Burden of ischemic heart disease in China from 1990 to 2021: Data from the global disease burden database 2021 1990 - 2021年中国缺血性心脏病负担：来自2021年全球疾病负担数据库的数据

IF 2.1 Q3 PERIPHERAL VASCULAR DISEASE

International Journal of Cardiology Cardiovascular Risk and Prevention

Pub Date : 2025-12-01 Epub Date: 2025-08-09 DOI: 10.1016/j.ijcrp.2025.200489

Zibo Lin , Ting Ren , Zhe Wang, Mi Zhou, Haiqing Li, Yunpeng Zhu, Hong Xu, Yanjun Sun, Jiapei Qiu, Qiang Zhao

Objectives

This study aims to analyze the disease burden of ischemic heart disease (IHD) in China from 1990 to 2021 utilizing data from Global Burden of Disease (GBD) 2021 database.

Methods

Data from the GBD 2021 database were used to evaluate the prevalence, incidence, mortality, disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs) attributable to IHD in China from 1990 to 2021. Age-standardized rates and Joinpoint analysis were employed to assess temporal trends, with comparisons across gender and age groups.

Results

In 2021, the incidence rate was 365.67 per 100,000 population (95 % CI: 293.32–440.07), and the mortality rate was 110.91 per 100,000 population (95 % CI: 92.42–128.56). Males exhibited a significantly higher disease burden compared to females. Among the population, incidence rates increased markedly after age 60, peaking at ages 70–74, while mortality rates rose sharply after age 75. From 1990 to 2021, the incidence, prevalence, mortality, and DALY rates showed an upward trend. However, after age standardization, the trends for incidence and prevalence flattened, while mortality and DALY rates showed a downward trend. Joinpoint analysis indicated a downward trend in age-standardized incidence, prevalence, mortality, and DALY rates.

Conclusion

The overall burden of IHD in China remains high, but age-standardized data reflects the effectiveness of disease prevention and control. In the future, greater emphasis should be placed on high-risk populations, particularly aging population and postmenopausal women, to further alleviate the social burden of IHD.

目的利用全球疾病负担（GBD） 2021数据库的数据，分析1990 - 2021年中国缺血性心脏病（IHD）的疾病负担。方法采用GBD 2021数据库的数据，评估1990年至2021年中国IHD的患病率、发病率、死亡率、残疾调整生命年（DALYs）、残疾生活年（YLDs）和生命损失年（YLLs）。采用年龄标准化率和Joinpoint分析来评估时间趋势，并对性别和年龄组进行比较。结果2021年发病率为365.67 / 10万人（95% CI: 293.32 ~ 440.07），死亡率为110.91 / 10万人（95% CI: 92.42 ~ 128.56）。男性的疾病负担明显高于女性。在人群中，发病率在60岁以后显著增加，在70-74岁达到高峰，而死亡率在75岁以后急剧上升。从1990年到2021年，发病率、患病率、死亡率和DALY率呈上升趋势。然而，在年龄标准化之后，发病率和患病率的趋势趋于平缓，而死亡率和DALY率则呈下降趋势。联合点分析显示年龄标准化发病率、患病率、死亡率和DALY率呈下降趋势。结论中国IHD的总体负担仍然很高，但年龄标准化数据反映了疾病预防和控制的有效性。今后应更加重视高危人群，特别是老龄人口和绝经后妇女，进一步减轻IHD的社会负担。

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引用次数: 0

Impact of vitamin D insufficiency on cardiac function in patients with systemic sclerosis 维生素D不足对系统性硬化症患者心功能的影响

IF 2.1 Q3 PERIPHERAL VASCULAR DISEASE

International Journal of Cardiology Cardiovascular Risk and Prevention

Pub Date : 2025-12-01 Epub Date: 2025-11-19 DOI: 10.1016/j.ijcrp.2025.200546

Susan Darroudi , Leila Bigdelu

This is a commentary on a recent research paper about the link between vitamin D deficiency and cardiovascular compromise in systemic sclerosis (SSc) patients. The study is a sound report and contributes significantly to knowledge about the cardiovascular impact of vitamin D deficiency. Strengths are adherence to ethical and diagnostic guidelines throughout, thorough cardiopulmonary characterization, and complete data acquisition. However, the absence of dietary and adiposity data (for example, energy intake), the possibility of a selection bias, as well as assumptions on parametrization for categorical variables could all introduce some limitations to our findings.Nevertheless, despite these limitations, the study indeed adds significant value to our knowledge on how vitamin D status interplays with cardiac remodeling amongst individuals with SSc and highlights the need for more mechanistic/intervention work.

这是对最近一篇关于系统性硬化症（SSc）患者维生素D缺乏与心血管损害之间联系的研究论文的评论。这项研究是一份可靠的报告，对了解维生素D缺乏对心血管的影响有重要贡献。优点是始终坚持道德和诊断指南，彻底的心肺特征和完整的数据采集。然而，缺乏饮食和肥胖数据（例如，能量摄入），选择偏差的可能性，以及对分类变量参数化的假设，都可能给我们的研究结果带来一些局限性。然而，尽管存在这些局限性，该研究确实为我们了解维生素D状态如何与SSc个体的心脏重塑相互作用增加了重要价值，并强调了更多机制/干预工作的必要性。

引用次数: 0

Vitamin D in systemic sclerosis: Why multivariable adjustment matters 维生素D在系统性硬化症中的作用：为什么多变量调整很重要

IF 2.1 Q3 PERIPHERAL VASCULAR DISEASE

International Journal of Cardiology Cardiovascular Risk and Prevention

Pub Date : 2025-12-01 Epub Date: 2025-10-16 DOI: 10.1016/j.ijcrp.2025.200532

Aurora Vicenzi

引用次数: 0

Circulating-free DNA and myocardial infarction: From diagnostic promise to clinical translation 无循环DNA与心肌梗死：从诊断前景到临床转化

IF 2.1 Q3 PERIPHERAL VASCULAR DISEASE

International Journal of Cardiology Cardiovascular Risk and Prevention

Pub Date : 2025-12-01 Epub Date: 2025-09-17 DOI: 10.1016/j.ijcrp.2025.200517

Jeff Clyde G. Corpuz

This correspondence responds to the review by Rafiei et al. on circulating-free DNA (cfDNA) as a biomarker for early detection of myocardial infarction (MI). CfDNA shows potential for rapid diagnosis and real-time monitoring, but major barriers remain. Lack of standardized testing methods, uncertain utility in emergency care, and high costs risk delaying adoption and widening health inequities, particularly in low- and middle-income countries (LMICs). Key priorities include harmonizing laboratory protocols, developing point-of-care platforms, and integrating cfDNA into diagnostic algorithms with cardiac troponins and electrocardiograms (ECG). Research should focus on large, long-term cohorts that include diverse populations, and test multi-marker strategies combining cfDNA with microRNAs and DNA methylation profiles. Ensuring affordability and accessibility will be critical to translate cfDNA from experimental promise to routine cardiovascular practice.

这篇文章回应了Rafiei等人关于游离循环DNA （cfDNA）作为早期检测心肌梗死（MI）的生物标志物的综述。CfDNA显示出快速诊断和实时监测的潜力，但主要障碍仍然存在。缺乏标准化的检测方法，急诊护理的效用不确定，以及高昂的费用，有可能推迟采用和扩大卫生不公平现象，特别是在低收入和中等收入国家。关键优先事项包括协调实验室方案，开发护理点平台，以及将cfDNA整合到心脏肌钙蛋白和心电图（ECG）的诊断算法中。研究应侧重于包括不同人群的大型长期队列，并测试将cfDNA与microrna和DNA甲基化谱结合起来的多标记策略。确保可负担性和可获得性对于将cfDNA从实验承诺转化为常规心血管实践至关重要。

引用次数: 0

Chronic emotional stress and mediating role of Interleukin-6 in the association with cardiometabolic disorders in a multiethnic middle-aged and older US population 慢性情绪应激和白细胞介素-6在美国多种族中老年人群中与心脏代谢疾病相关的中介作用

IF 2.1 Q3 PERIPHERAL VASCULAR DISEASE

International Journal of Cardiology Cardiovascular Risk and Prevention

Pub Date : 2025-12-01 Epub Date: 2025-09-06 DOI: 10.1016/j.ijcrp.2025.200510

Asma Hallab , The Health and Aging Brain Study (HABS-HD) Study Team

Introduction

Chronic emotional stress is a well-recognized risk factor for psychiatric and cardiometabolic disorders. The mediating role of low-grade inflammation in older, ethnically diverse populations has never been studied.

Methods

The multiethnic ≥50-year-old study population is a subset of the Health and Aging Brain Study: Health Disparities (HABS-HD) study. Adjusted logistic and linear regression were used to assess associations. Statistical mediation analysis with non-parametric bootstrapping of confidence intervals was used to determine the intermediate role of Interleukin-6 (IL-6).

Results

The study included 2173 participants (50–92 years). Black participants disclosed higher chronic stress levels than White and Hispanic participants. Having a chronic stress total score ≥ six points is associated with 53 % higher odds of disclosing concomitant cardiovascular disease (CVD) (adj.OR = 1.53 [1.10–2.53]), 31 % of Type-2 diabetes (T₂DM) (adj.OR = 1.31[1.06–1.62]), 23 % of hypertension (adj.OR = 1.23 [1.02–1.49]), and 30 % obesity (adj.OR = 1.3[1.09–1.55]). These associations were statistically mediated by IL-6 (12 % (p-value_FDR = 0.012) of the association with CVD, 17 % T₂DM (p-value_FDR<0.001), 18 % hypertension (p-value_FDR<0.001), and 29 % obesity (p-value_FDR = 0.005)).

Conclusions

The study highlights a further aspect of the pathophysiological mechanisms involved in the brain-body communication. While IL-6 partially explains statistical associations between chronic emotional stress and major cardiometabolic disorders, no causal effects can be inferred from this study owing to the cross-sectional design. Larger longitudinal studies are needed to better clarify the temporal relationship between the events and to build upon our findings.

慢性情绪压力是公认的精神疾病和心脏代谢疾病的危险因素。低度炎症在老年人、不同种族人群中的中介作用从未被研究过。方法多民族≥50岁的研究人群是健康与衰老脑研究：健康差异（HABS-HD）研究的一个子集。采用调整后的逻辑回归和线性回归来评估相关性。采用非参数置信区间的统计中介分析来确定白细胞介素-6 （IL-6）的中间作用。结果本研究包括2173名参与者（50-92岁）。黑人参与者的慢性压力水平高于白人和西班牙裔参与者。慢性应激总分≥6分，伴有心血管疾病（CVD）的风险增加53% (adm . or = 1.53[1.10-2.53])， 2型糖尿病（T2DM）风险增加31% (adm . or = 1.31[1.06-1.62])，高血压风险增加23% (adm . or = 1.23[1.02-1.49])，肥胖风险增加30% （adm . or = 1.3[1.09-1.55]）。这些关联在统计学上由IL-6介导（12% （p-valueFDR = 0.012）与CVD、17% （p-valueFDR<0.001）、18%高血压（p-valueFDR<0.001）和29%肥胖（p-valueFDR = 0.005）相关）。结论本研究进一步揭示了脑-体交流的病理生理机制。虽然IL-6部分解释了慢性情绪压力与主要心脏代谢疾病之间的统计关联，但由于横断面设计，本研究无法推断出因果关系。需要更大规模的纵向研究来更好地阐明这些事件之间的时间关系，并以我们的发现为基础。

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引用次数: 0

SARS-CoV-2 infection, not vaccination, the true association between COVID-19 and myocardial infarction mortality: A nationwide study in Ecuador SARS-CoV-2感染，而不是疫苗接种，COVID-19与心肌梗死死亡率之间的真正联系：厄瓜多尔的一项全国性研究

IF 2.1 Q3 PERIPHERAL VASCULAR DISEASE

International Journal of Cardiology Cardiovascular Risk and Prevention

Pub Date : 2025-12-01 Epub Date: 2025-08-19 DOI: 10.1016/j.ijcrp.2025.200496

Esteban Ortiz-Prado , Vladimir Ullauri Solorzano , Diana Moreira-Vera , Jorge Vasconez-Gonzalez , Juan S. Izquierdo-Condoy

Background

Misinformation linking COVID-19 vaccines to myocardial infarction (MI) has fueled vaccine hesitancy, particularly in high-mortality settings like Ecuador. This study examines the association between COVID-19 infections, vaccinations, and MI mortality to address these concerns.

Objective

To investigate whether COVID-19 vaccinations or infections are associated with increased MI mortality in Ecuador.

Methods

This descriptive observational ecological time-series study analyzed 710 days of national health registry data from January 2021 to December 2022. The dataset included daily counts of myocardial infarction (MI) deaths, COVID-19 deaths, and COVID-19 vaccinations. Time-series regression models were used to assess the association between MI mortality (outcome) and both COVID-19 deaths and vaccination rates (predictors), with analyses stratified by sex.

Results

We recorded a total of 26,637 myocardial infarction (MI) deaths and 24,066 COVID-19 deaths during the study period. Daily COVID-19 deaths were significantly associated with an increase in MI mortality (β = 0.08667, p < 0.0001, R² = 0.2048), with a stronger effect observed in women (β = 0.1103, p < 0.0001) compared to men (β = 0.07343, p < 0.0001). Additionally, new COVID-19 cases were positively correlated with daily MI deaths (β = 0.002725, p < 0.0001, R² = 0.2543). In contrast, COVID-19 vaccination rates were associated with a small but statistically significant protective effect against MI mortality (β = −1.188e–5, p = 0.0218, R² = 0.0074).

Conclusion

COVID-19 infection, rather than vaccination, is strongly associated with increased myocardial infarction (MI) mortality in Ecuador. In contrast, the small but statistically significant protective effect observed for vaccination reinforces its cardiovascular safety and public health value. These findings directly counter prevailing misinformation linking vaccines to MI and provide evidence to support vaccination campaigns, particularly in high-risk and high-mortality settings.

将COVID-19疫苗与心肌梗死（MI）联系起来的错误信息加剧了对疫苗的犹豫，特别是在厄瓜多尔等死亡率高的国家。本研究探讨了COVID-19感染、疫苗接种和心肌梗死死亡率之间的关系，以解决这些问题。目的调查厄瓜多尔COVID-19疫苗接种或感染是否与心肌梗死死亡率增加有关。方法采用描述性观察生态时序研究，分析了2021年1月至2022年12月710天的国家健康登记数据。该数据集包括心肌梗死（MI）死亡、COVID-19死亡和COVID-19疫苗接种的每日计数。使用时间序列回归模型评估心肌梗死死亡率（结果）与COVID-19死亡率和疫苗接种率（预测因子）之间的关系，并按性别分层分析。结果在研究期间，共记录了26,637例心肌梗死（MI）死亡和24,066例COVID-19死亡。每日COVID-19死亡与心肌梗死死亡率增加显著相关（β = 0.08667, p < 0.0001, R2 = 0.2048），与男性（β = 0.07343, p < 0.0001）相比，女性（β = 0.1103, p < 0.0001）的影响更大。此外，新发COVID-19病例与每日心肌梗死死亡呈正相关（β = 0.002725, p < 0.0001, R2 = 0.2543）。相比之下，COVID-19疫苗接种率对心肌梗死死亡率的保护作用虽小，但具有统计学意义（β = - 1.188e-5, p = 0.0218, R2 = 0.0074）。结论与厄瓜多尔心肌梗死（MI）死亡率增加密切相关的是covid -19感染，而不是疫苗接种。相比之下，疫苗接种所观察到的虽小但统计上显著的保护作用强化了其心血管安全性和公共卫生价值。这些发现直接反驳了将疫苗与心肌梗死联系起来的普遍错误信息，并为支持疫苗接种运动提供了证据，特别是在高风险和高死亡率环境中。

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引用次数: 0