Systematic Reviews
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 6, 2022; 10(28): 10109-10119
Published online Oct 6, 2022. doi: 10.12998/wjcc.v10.i28.10109
Link between COVID-19 vaccines and myocardial infarction
Umema Zafar, Hamna Zafar, Mian Saad Ahmed, Madiha Khattak
Umema Zafar, Madiha Khattak, Department of Physiology, Khyber Medical College, Peshawar 25000, Pakistan
Hamna Zafar, Department of Medicine, Khyber Teaching Hospital, Peshawar 25000, Pakistan
Mian Saad Ahmed, Department of Forensic Medicine, Khyber Medical College, Peshawar 25000, Pakistan
Author contributions: Zafar U and Zafar H designed the research and analyzed the data and checked paper for final review; Ahmed MS and Khattak M performed the research and wrote the paper.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised in accordance with this checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Umema Zafar, MBBS, MPhil, Assistant Professor, Doctor, Department of Physiology, Khyber Medical College, Peshawar University Campus, Peshawar 25000, Pakistan. umema.com@gmail.com
Received: May 30, 2022
Peer-review started: May 30, 2022
First decision: July 14, 2022
Revised: July 20, 2022
Accepted: September 1, 2022
Article in press: September 1, 2022
Published online: October 6, 2022
Processing time: 119 Days and 23.9 Hours
Abstract
BACKGROUND

Vaccines for coronavirus disease 2019 (COVID-19) include ChAdOx1-SARS-COV-2 (AstraZeneca), Ad26.COV2.S (Janssen), mRNA-1273 (Moderna), BNT162b2 (Pfizer), BBIBP-CorV (Sinopharm), CoronaVac (Sinovac), and Bharat Biotech BBV152 (Covaxin).

AIM

To find the association between COVID-19 vaccines and myocardial infarction (MI).

METHODS

This is a systematic review that involved searching databases such as MEDLINE, EMBASE, and PakMediNet after making a search strategy using MeSH and Emtree terms. Eligibility criteria were set, and studies having no mention of MI as a complication of COVID-19 vaccination, protocols, genetic studies, and animal studies were excluded. Data was extracted using a predesigned extraction table, and 29 studies were selected after screening and applying the eligibility criteria.

RESULTS

The majority of studies mentioned AstraZeneca (18 studies) followed by Pfizer (14 studies) and Moderna (9 studies) in subjects reporting MI after vaccination. Out of all the studies, 69% reported MI cases after the first COVID-19 vaccination dose and 14% after the second, 44% reported ST-segment elevation MI, and 26% reported non-ST-segment elevation MI. The mortality rate was 29% after MI.

CONCLUSION

In conclusion, many studies linked MI to COVID-19 vaccinations, but no definitive association could be found.

Keywords: SARS-CoV-2 infection; Vaccination; Myocardial infarction; Association; Pfizer; AstraZeneca; Moderna; Sinovac; Janssen; Covaxin

Core Tip: Mechanisms like vaccine-induced thrombotic thrombocytopenia and myocarditis complication have been identified in the literature linking myocardial infarction with coronavirus disease 2019 (COVID-19) vaccination. The majority of myocardial infarction cases reported were after vaccination with the vaccine from AstraZeneca, were ST-segment elevation, and were reported after first dose of vaccine. Although there are reports of myocardial infarction after COVID-19 vaccination, no definitive link was found in the previous literature linking the two.