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ORIGINAL RESEARCH article

Front. Cardiovasc. Med.
Sec. General Cardiovascular Medicine
Volume 11 - 2024 | doi: 10.3389/fcvm.2024.1435038

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

Provisionally accepted
Samipa Pudasaini Samipa Pudasaini Ngoc H. Le Ngoc H. Le Dörte Huscher Dörte Huscher Fabian Holert Fabian Holert David Hillus David Hillus Pinkus Tober-Lau Pinkus Tober-Lau Florian Kurth Florian Kurth Leif E. Sander Leif E. Sander Martin Möckel Martin Möckel *
  • Charité University Medicine Berlin, Berlin, Germany

The final, formatted version of the article will be published soon.

    Background: COVID-19 vaccines are well tolerated and effective but may have adverse events 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 4ng/L, 5ng/L and 4ng/L (V1-V3) for AZ/BNT and at 5ng/L, 6ng/L and 6ng/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. MR-proADM values were 0.43nmol/L, 0.45nmol/L, 0.44nmol/L (V1-V3) in the AZ/BNT cohort and 0.49nmol/L, 0.44nmol/L, 0.47nmol/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 ≥14ng/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.

    Keywords: COVID-19 vaccination, High-sensitive troponin T, persistent myocardial injury, Mid-regional pro-adrenomedullin, endothelial dysfunction

    Received: 19 May 2024; Accepted: 30 Sep 2024.

    Copyright: © 2024 Pudasaini, Le, Huscher, Holert, Hillus, Tober-Lau, Kurth, Sander and Möckel. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Martin Möckel, Charité University Medicine Berlin, Berlin, Germany

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