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Correspondence to Author: Delio Tiago Martins Malaquias¹, Joel Eloi Belo Junior¹⁰, Leocadia Felix de Araújo⁹; Douglas Hipólito Carvalho⁴; Larissa Lauretto², Ana Clara Lobo Ribeiro³, Enzo Maruzzo Marques⁵, Felix Adriano Pietroluongo Vidal Tabera⁴, Victoria Geovana Tobias⁴, Samantha Regina Galo Sanches¹, Felipe Gomes Lacerda¹; Andre Luiz Vergamini Dias⁴, Ingrid de Mariz Zane⁴, Maria Heloisa Martins Gimenes Gomes¹, Giovana Casarini Yamashiro⁴, Aline Cristina Couto da Silva¹, Rubens Rodrigues Tutela⁶, José Antônio do Nascimento Neto⁷, Francisco Rogério de Sousa Mota⁷, Renata Zamboni Lança², Orseli Marques Ferreira Neto⁸, Thiago Augusto Rochetti Bezerra^1*. 

¹ Medical student. Ribeirão Preto University – UNAERP, Guarujá/SP, Brazil.
² Medical Student. University of Western São Paulo – UNOESTE, Guarujá/SP, Brazil.
³ Medical Student. University of Rio Verde – UNIRV, Aparecida de Goiânia Campus/GO, Brazil.
⁴ Medical student. Nove de Julho University – UNINOVE, São Bernardo do Campo/SP, Brazil.
⁵ Medical Student. São José dos Campos School of Medical Sciences – Humanitas, Brazil.
⁶ Medical student. São Judas University – São Paulo/SP, Brazil.
⁷ Medical student. Universidad Central del Paraguay – Ciudad del Este, Paraguay.
⁸ Graduated in Medicine from the University of Rio Verde Campus Aparecida, Goiás, Brazil.
⁹ Graduated in Medicine from the Federal University of Fronteira Sul, Passo Fundo Campus, Rio Grande do Sul, Brazil.
* PhD. of Medical Sciences. Ribeirão Preto School of Medicine, USP, Brazil.
¹⁰ Major Aviator of the Brazilian Air Force; Master’s degree in Human Operational Performance; Master’s degree in Intellectual Property and Technology Transfer for Innovation

DOI: 10.52338/apps.2025.5135

Abstract:

Introduction: The COVID-19 pandemic has required the rapid development of vaccines on a large scale. Although the benefits of vaccination in reducing hospitalizations and deaths are widely documented, questions have arisen about possible adverse cardiovascular events, particularly acute myocardial infarction (AMI) and post-ischemic heart failure. Objective: To critically synthesize the evidence available between 2021 and 2025 on the occurrence of AMI and post-ischemic heart failure after COVID-19 vaccination, considering different vaccine platforms and comparing them with the risks arising from SARS-CoV-2 infection itself.
Methodology: This is a systematic review conducted according to the PRISMA 2020 protocol. The PubMed/MEDLINE, Embase, Scopus, Web of Science, SciELO databases, and preprint registries (medRxiv and bioRxiv) were consulted, covering publications from 2021 to 2025. Clinical trials, observational studies, series, and case reports describing AMI and/or heart failure after vaccination were included. Methodological quality was assessed using validated tools (Newcastle-Ottawa Scale, RoB 2, AMSTAR-2).
Results: A total of 1,384 articles were identified, of which 42 met the inclusion criteria. In total, the studies included more than 45 million vaccinees in different regions of the world. The incidence of post-vaccination AMI was low (2 to 5 cases per 100,000 individuals), with no significant increase in risk in pooled analyses (RR = 1.02; 95% CI 0.95–1.10). For post-ischemic heart failure, there was no causal association with vaccination (RR = 0.97; 95% CI 0.88–1.05). In contrast, SARS-CoV-2 infection was associated with a substantial increase in risk (RR = 6.0 for AMI and RR = 8.0 for heart failure). Recent studies reinforce the indirect protective effect of vaccination in preventing cardiovascular complications resulting from COVID-19.
Discussion:The data corroborate the cardiovascular safety of COVID-19 vaccines, even in more vulnerable subgroups. Rare events, such as myocarditis associated with mRNA vaccines and post-adenoviral thrombosis with thrombocytopenia, have been described but did not impact the incidence of AMI or heart failure at the population level. Vaccination, therefore, presents a largely favorable benefit-risk balance, while infection remains a relevant factor for acute and chronic cardiovascular risk.

Citation:

Dr. Thiago Augusto Rochetti Bezerra, Systematic Review On Acute Myocardial Infarction And Post-Ischemic Heart Failure After Covid-19 Vaccination: Current Evidence On The Effects Of Vaccines. In Each Paragraph, Cite References From 2021 To 2025. Annals of Pharmacology and Pharmaceutical Sciences 2025.