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

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.