Samipa Pudasaini, Ngoc Han Le, Dörte Huscher, Fabian Holert, David Hillus, Pinkus Tober-Lau, Florian Kurth, Leif Erik Sander, Martin Möckel
{"title":"弱势群体接种 COVID-19 疫苗后的高敏肌钙蛋白 T 和中区前肾上腺髓质素水平：监测 COVID-19 疫苗接种的心血管安全性。","authors":"Samipa Pudasaini, Ngoc Han Le, Dörte Huscher, Fabian Holert, David Hillus, Pinkus Tober-Lau, Florian Kurth, Leif Erik Sander, Martin Möckel","doi":"10.3389/fcvm.2024.1435038","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>COVID-19 vaccines are well tolerated and effective but may have adverse effects on the cardiovascular system. Vaccine-associated myocardial injury was analysed by measuring high-sensitive troponin T (hsTnT); mid-regional pro-adrenomedullin (MR-proADM) levels were evaluated to assess endothelial dysfunction.</p><p><strong>Methods: </strong>This was a prospective study with a vulnerable population of healthcare workers (HCWs) and elderly patients (>70 years) who were vaccinated with either one dose of ChAdOx1 nCov-19 adenoviral vector vaccine (AZ) followed by one dose of the BNT162b2 messenger RNA vaccine (BNT), or with two doses of BNT (12th of January - 30th of November 2021). HsTnT and MR-proADM were measured in blood samples at three visits (V<sub>1</sub>: 1st immediately before vaccination; V<sub>2, 3</sub>: 3-4 weeks after 1st and 2nd vaccination). HsTnT of HCWs was compared to a healthy reference population.</p><p><strong>Results: </strong><i>N</i> = 162 volunteers were included (V<sub>1</sub> = 161; V<sub>2</sub>, V<sub>3</sub> = 162 each). <i>N</i> = 74 (45.7%) received AZ/BNT and <i>n</i> = 88 (54.3%) received BNT/BNT [elderly: <i>n</i> = 20 (12.3%), HCWs: <i>n</i> = 68 (42.0%)]. Median hsTnT levels were 4 ng/L, 5 ng/L and 4 ng/L (V<sub>1</sub>-V<sub>3</sub>) for AZ/BNT and at 5 ng/L, 6 ng/L and 6 ng/L (V<sub>1</sub>-V<sub>3</sub>) for BNT/BNT. Compared to the reference population (<i>n</i> = 300), hsTnT was significantly higher at all visits for both vaccination groups (<i>p</i> < 0.01), without differences between the AZ/BNT and BNT/BNT cohort. Median MR-proADM values were 0.43 nmol/L, 0.45 nmol/L, 0.44 nmol/L (V<sub>1</sub>-V<sub>3</sub>) in the AZ/BNT cohort and 0.49 nmol/L, 0.44 nmol/L, 0.47 nmol/L for BNT/BNT, respectively. Change of median hsTnT and MR-proADM between visits did not show significant increases. One HCW experienced a permanent and three a transient hsTnT increase ≥14 ng/L.</p><p><strong>Conclusion: </strong>No overall subtle, persistent cardiovascular involvement was observed after the 2nd COVID-19 vaccination. Elevated cardiovascular biomarkers in clinically asymptomatic individuals need further investigations.</p>","PeriodicalId":12414,"journal":{"name":"Frontiers in Cardiovascular Medicine","volume":"11 ","pages":"1435038"},"PeriodicalIF":2.8000,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11527644/pdf/","citationCount":"0","resultStr":"{\"title\":\"Levels of high-sensitive troponin T and mid-regional pro-adrenomedullin after COVID-19 vaccination in vulnerable groups: monitoring cardiovascular safety of COVID-19 vaccination.\",\"authors\":\"Samipa Pudasaini, Ngoc Han Le, Dörte Huscher, Fabian Holert, David Hillus, Pinkus Tober-Lau, Florian Kurth, Leif Erik Sander, Martin Möckel\",\"doi\":\"10.3389/fcvm.2024.1435038\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>COVID-19 vaccines are well tolerated and effective but may have adverse effects on the cardiovascular system. Vaccine-associated myocardial injury was analysed by measuring high-sensitive troponin T (hsTnT); mid-regional pro-adrenomedullin (MR-proADM) levels were evaluated to assess endothelial dysfunction.</p><p><strong>Methods: </strong>This was a prospective study with a vulnerable population of healthcare workers (HCWs) and elderly patients (>70 years) who were vaccinated with either one dose of ChAdOx1 nCov-19 adenoviral vector vaccine (AZ) followed by one dose of the BNT162b2 messenger RNA vaccine (BNT), or with two doses of BNT (12th of January - 30th of November 2021). HsTnT and MR-proADM were measured in blood samples at three visits (V<sub>1</sub>: 1st immediately before vaccination; V<sub>2, 3</sub>: 3-4 weeks after 1st and 2nd vaccination). HsTnT of HCWs was compared to a healthy reference population.</p><p><strong>Results: </strong><i>N</i> = 162 volunteers were included (V<sub>1</sub> = 161; V<sub>2</sub>, V<sub>3</sub> = 162 each). <i>N</i> = 74 (45.7%) received AZ/BNT and <i>n</i> = 88 (54.3%) received BNT/BNT [elderly: <i>n</i> = 20 (12.3%), HCWs: <i>n</i> = 68 (42.0%)]. Median hsTnT levels were 4 ng/L, 5 ng/L and 4 ng/L (V<sub>1</sub>-V<sub>3</sub>) for AZ/BNT and at 5 ng/L, 6 ng/L and 6 ng/L (V<sub>1</sub>-V<sub>3</sub>) for BNT/BNT. Compared to the reference population (<i>n</i> = 300), hsTnT was significantly higher at all visits for both vaccination groups (<i>p</i> < 0.01), without differences between the AZ/BNT and BNT/BNT cohort. Median MR-proADM values were 0.43 nmol/L, 0.45 nmol/L, 0.44 nmol/L (V<sub>1</sub>-V<sub>3</sub>) in the AZ/BNT cohort and 0.49 nmol/L, 0.44 nmol/L, 0.47 nmol/L for BNT/BNT, respectively. Change of median hsTnT and MR-proADM between visits did not show significant increases. One HCW experienced a permanent and three a transient hsTnT increase ≥14 ng/L.</p><p><strong>Conclusion: </strong>No overall subtle, persistent cardiovascular involvement was observed after the 2nd COVID-19 vaccination. Elevated cardiovascular biomarkers in clinically asymptomatic individuals need further investigations.</p>\",\"PeriodicalId\":12414,\"journal\":{\"name\":\"Frontiers in Cardiovascular Medicine\",\"volume\":\"11 \",\"pages\":\"1435038\"},\"PeriodicalIF\":2.8000,\"publicationDate\":\"2024-10-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11527644/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Frontiers in Cardiovascular Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3389/fcvm.2024.1435038\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Cardiovascular Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fcvm.2024.1435038","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Levels of high-sensitive troponin T and mid-regional pro-adrenomedullin after COVID-19 vaccination in vulnerable groups: monitoring cardiovascular safety of COVID-19 vaccination.
Background: COVID-19 vaccines are well tolerated and effective but may have adverse effects on the cardiovascular system. Vaccine-associated myocardial injury was analysed by measuring high-sensitive troponin T (hsTnT); mid-regional pro-adrenomedullin (MR-proADM) levels were evaluated to assess endothelial dysfunction.
Methods: This was a prospective study with a vulnerable population of healthcare workers (HCWs) and elderly patients (>70 years) who were vaccinated with either one dose of ChAdOx1 nCov-19 adenoviral vector vaccine (AZ) followed by one dose of the BNT162b2 messenger RNA vaccine (BNT), or with two doses of BNT (12th of January - 30th of November 2021). HsTnT and MR-proADM were measured in blood samples at three visits (V1: 1st immediately before vaccination; V2, 3: 3-4 weeks after 1st and 2nd vaccination). HsTnT of HCWs was compared to a healthy reference population.
Results: N = 162 volunteers were included (V1 = 161; V2, V3 = 162 each). N = 74 (45.7%) received AZ/BNT and n = 88 (54.3%) received BNT/BNT [elderly: n = 20 (12.3%), HCWs: n = 68 (42.0%)]. Median hsTnT levels were 4 ng/L, 5 ng/L and 4 ng/L (V1-V3) for AZ/BNT and at 5 ng/L, 6 ng/L and 6 ng/L (V1-V3) for BNT/BNT. Compared to the reference population (n = 300), hsTnT was significantly higher at all visits for both vaccination groups (p < 0.01), without differences between the AZ/BNT and BNT/BNT cohort. Median MR-proADM values were 0.43 nmol/L, 0.45 nmol/L, 0.44 nmol/L (V1-V3) in the AZ/BNT cohort and 0.49 nmol/L, 0.44 nmol/L, 0.47 nmol/L for BNT/BNT, respectively. Change of median hsTnT and MR-proADM between visits did not show significant increases. One HCW experienced a permanent and three a transient hsTnT increase ≥14 ng/L.
Conclusion: No overall subtle, persistent cardiovascular involvement was observed after the 2nd COVID-19 vaccination. Elevated cardiovascular biomarkers in clinically asymptomatic individuals need further investigations.
期刊介绍：
Frontiers? Which frontiers? Where exactly are the frontiers of cardiovascular medicine? And who should be defining these frontiers?
At Frontiers in Cardiovascular Medicine we believe it is worth being curious to foresee and explore beyond the current frontiers. In other words, we would like, through the articles published by our community journal Frontiers in Cardiovascular Medicine, to anticipate the future of cardiovascular medicine, and thus better prevent cardiovascular disorders and improve therapeutic options and outcomes of our patients.
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