Influence of Preoperative COVID-19 Vaccination on Outcomes After Coronary Artery Bypass Grafting-A Propensity Score-Matched Analysis

J Am Heart Assoc. 2024 Mar 19;13(6):e032426. doi: 10.1161/JAHA.123.032426. Epub 2024 Mar 12.

Abstract

Background: Reports of intravascular thrombosis and cardiac complications have raised concerns about the safety of COVID-19 vaccinations, particularly in patients with high cardiovascular risk. Herein, we aimed to analyze the impact of preoperative COVID-19 vaccination on outcomes after coronary artery bypass grafting (CABG).

Methods and results: Among 520 patients who underwent isolated CABG from 2020 to 2022, 481 patients (mean±SD age: 67±11 years, 86 women) whose COVID-19 vaccination status could be confirmed were included. A total of 249 patients who had not received any COVID-19 vaccine before CABG (never vaccinated group) and 214 patients who had completed primary vaccination (fully vaccinated group) were subjected to 1:1 propensity score matching, and 156 pairs of patients were matched. There was no significant difference in early mortality between the 2 groups after matching. After matching, overall survival (P=0.930) and major adverse cardiovascular and cerebrovascular event-free survival (P=0.636) did not differ between the 2 groups. One-year graft patency also did not differ significantly between the 2 groups; all patent grafts in 85/104 patients (82%) and 62/73 patients (85%) in the never vaccinated and fully vaccinated groups, respectively (P=0.685). Subgroup analysis showed equivalent overall and major adverse cardiovascular and cerebrovascular event-free survival among AstraZeneca and Pfizer vaccine recipients and between those with ≤30 days versus >30 days from vaccination to CABG.

Conclusions: Despite the very high cardiovascular risk for patients undergoing CABG, COVID-19 vaccination did not affect major outcomes after CABG. Therefore, there is no reason for patients with coronary artery disease requiring CABG to avoid preoperative COVID-19 vaccination.

Keywords: COVID‐19; COVID‐19 vaccines; coronary artery bypass; coronavirus.

MeSH terms

  • Aged
  • COVID-19 Vaccines / administration & dosage
  • COVID-19* / complications
  • COVID-19* / epidemiology
  • COVID-19* / prevention & control
  • Coronary Artery Bypass
  • Coronary Artery Disease* / complications
  • Female
  • Humans
  • Middle Aged
  • Propensity Score
  • Retrospective Studies
  • Treatment Outcome
  • Vaccination

Substances

  • COVID-19 Vaccines