Arrhythmias & electrophysiology
Sex-based differences in risk of ischaemic stroke or systemic embolism after BNT162b2 or CoronaVac COVID-19 vaccination in patients with atrial fibrillation: a self-controlled case series and nested case-control study
Authors' conclusion
The risk of ischaemic stroke or systemic embolism after COVID-19 vaccination was only increased in female patients with AF.
Study context
- Population
- Patients with atrial fibrillation (AF) hospitalised for ischaemic stroke, systemic embolism or bleeding, Hong Kong, 23 February 2021–31 March 2022patients with AF
- Participants
- 51,158 patients
- Comparison
- Risk periods after BNT162b2 or CoronaVac vaccination vs baseline/unexposed, by sex
- Outcome
- Ischaemic stroke or systemic embolism, and bleeding, after COVID-19 vaccination
Methodological detailsterritory-wide electronic medical records, nested case-control with 10 matched controls per case, stratified by sex and vaccine type
- Territory-wide electronic medical records
- Nested case-control with 10 matched controls per case
- Stratified by sex and vaccine type
Main finding
As reported in the abstract
Ischaemic stroke or systemic embolism after first dose, female patients
Estimate (95% CI)
BNT162b2SCCS, females, 0-13 days
IRR 6.60(1.51–28.77)
BNT162b2SCCS, females, 14-27 days
IRR 6.53(1.31–32.51)
BNT162b2nested case-control, females, 0-13 days
adjusted OR 6.21(1.14–33.91)
BNT162b2nested case-control, females, 14-27 days
adjusted OR 5.52(1.12–27.26)
CoronaVacnested case-control, females, 0-13 days; only increased period
adjusted OR 3.88(1.67–9.03)
Observational data: associations, not effects.
Further findings
| Outcome | Estimate |
|---|---|
| Ischaemic stroke or systemic embolism after COVID-19 (infection)COVID-19 · females | 17.42 (95% CI 5.08–59.73) |
| Ischaemic stroke or systemic embolism after COVID-19 (infection)COVID-19 · males | 6.63 (95% CI 2.02–21.79) |
Safety
- No increased risk of bleeding in all patients with AF for both vaccines
Original publication
Sex-based differences in risk of ischaemic stroke or systemic embolism after BNT162b2 or CoronaVac COVID-19 vaccination in patients with atrial fibrillation: a self-controlled case series and nested case-control study. Eur Heart J Cardiovasc Pharmacother. Published 14 March 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →