AUTHOR=Pudasaini Samipa , Le Ngoc Han , Huscher Dörte , Holert Fabian , Hillus David , Tober-Lau Pinkus , Kurth Florian , Sander Leif Erik , Möckel Martin 

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

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=11

YEAR=2024

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2024.1435038

DOI=10.3389/fcvm.2024.1435038

ISSN=2297-055X

ABSTRACT=<sec><title>Background</title><p>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></sec><sec><title>Methods</title><p>This was a prospective study with a vulnerable population of healthcare workers (HCWs) and elderly patients (&gt;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></sec><sec><title>Results</title><p><italic>N</italic> = 162 volunteers were included (V<sub>1</sub> = 161; V<sub>2</sub>, V<sub>3</sub> = 162 each). <italic>N</italic> = 74 (45.7%) received AZ/BNT and <italic>n</italic> = 88 (54.3%) received BNT/BNT [elderly: <italic>n</italic> = 20 (12.3%), HCWs: <italic>n</italic> = 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 (<italic>n</italic> = 300), hsTnT was significantly higher at all visits for both vaccination groups (<italic>p</italic> &lt; 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></sec><sec><title>Conclusion</title><p>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></sec>