BNT162b2 mRNA COVID-19 vaccine induces recurrent acute coronary syndromes in coronary artery disease patients with coronary stents: a case report

Abstract

INTRODUCTION: Reports of COVID-19 vaccine-associated adverse events have gradually become widespread. Here, we present a case of recurrent acute coronary syndrome (ACS) after administration of the BNT162b2 mRNA COVID-19 vaccine (Pfizer-BioNTech), speculating that it probably occurs via a micro-emboli formation mechanism. CASE PRESENTATION: We describe a case of recurrent ACS in a 70-year-old man with multiple coronary stents after receiving the BNT162b2 mRNA COVID-19 vaccine (Pfizer-BioNTech). This patient experienced recurrent angina pectoris after the implantation of his third stent. An electrocardiogram (ECG) and elevated serum troponin I levels confirmed myocardial ischemia. The patient’s symptoms were partially relieved after his anticoagulation (AC) and antiplatelet (AP) regimen had been adjusted and disappeared 3 months after the vaccination. CONCLUSION: We speculate that the BNT162b2 mRNA COVID-19 vaccine could increase the risk of recurrent ACS in coronary artery disease (CAD) patients with coronary stents; antithrombotic therapy may need to be strengthened in the case of such patients receiving a vaccination. (Am J Transl Med 2022. 6(4):185-190)