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Xue-Yan Gong, James Cheng-Chung Wei, Li-Yun Zhang, Possible perspectives for cardiovascular events following coronavirus disease 2019 vaccination, European Heart Journal, 2025;, ehaf112, https://doi.org/10.1093/eurheartj/ehaf112
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This commentary refers to ‘Cardiovascular events following coronavirus disease 2019 vaccination in adults: a nationwide Swedish study’, by Y. Xu et al., https://doi.org/10.1093/eurheartj/ehae639.
We have read with great interest the article written by Xu et al.,1 which reports the protective benefits of complete vaccination in cardiovascular system. Subsequently, we would like to emphasize certain key concerns we have with regards to the article.
Firstly, the large-scale study was based on more than 8 million Swedish adults. Past study has reported that the effect of vaccination is influenced by large variation across populations and geographic regions.2 There is a limitation in reflecting the situation in other countries and regions. Adding data from different ethnic and geographic regions could help generalize the conclusion of the protective effects of complete vaccination to the wider population.
Secondly, despite adjusting for many known confounders (gender, education, comorbidities, treatments, etc.), there are still several important confounding factors which could altered incidence of cardiovascular events, such as lifestyle (e.g. smoking, exercise, and eating habits) and socioeconomic status (nutritional status, medical conditions, etc.).3 Thus, a more detailed analysis of these variates could help to control confounding effects and understand their potential impact on the observed outcomes. This will facilitate a more accurate adjustment to the study and better clarify the protective effect of full vaccination.