News in brief: Pfizer vaccine not causing CV events in elderly; Heart failure caution warranted with aspirin; Transparency register to reveal surgeon outcomes

Thursday, 25 Nov 2021

Pfizer vaccine not causing CV events in elderly

A French study of older people who received the Pfizer BNT162b2 mRNA COVID-19 vaccine has found no short-term increase in the incidence of acute myocardial infarction, stroke, and pulmonary embolism.

The study of nearly 3.9 million persons 75 years or older who had received at least 1 dose and 3.2 million who had received 2 doses found there was no increased risk of severe cardiovascular events in the 14 days following vaccination compared to non-risk periods.

The relative incidence (RI) for myocardial infarction 0.97 for the first dose and 1.04 for the second dose; for ischemic stroke 0.90 for the first dose and 0.92 for the second dose; for hemorrhagic stroke 0.90 for the first dose and 0.97 for the second dose; and for pulmonary embolism 0.85 for the first dose and 1.10 for the second dose.

The researchers said older people were underrepresented in phase 3 trials, however their findings also support other evidence from Israeli and US studies.

“Further investigations are needed to measure these risks in younger populations and for other types of vaccines against SARS-CoV-2,” they said.

Read more in JAMA

Heart failure caution warranted with aspirin

Aspirin use is associated with a 26% increased risk of heart failure (HF) in people with at least one predisposing factor for the condition.

The international study comprised 30,827 people with risk factors for HF including smoking, obesity, high blood pressure, high cholesterol, diabetes, and cardiovascular disease.

Participants were followed-up for more than five years for the first incidence of fatal or non-fatal heart failure requiring hospitalisation.

“This is the first study to report that among individuals with a least one risk factor for heart failure, those taking aspirin were more likely to subsequently develop the condition than those not using the medication,” study author Dr Blerim Mujaj said.

Dr Mujaj, from the University of Freiburg, Germany, said in a statement from the European Society of Cardiology that aspirin was used in 25% of the study cohort.

“Large multinational randomised trials in adults at risk for heart failure are needed to verify these results. Until then, our observations suggest that aspirin should be prescribed with caution in those with heart failure or with risk factors for the condition.”

Read more in ESC Heart Failure

Transparency register to reveal surgeon outcomes

A bill that will require surgeons and hospitals to be transparent about their surgical performance outcomes on a public register has had its second reading in Senate.

The Health Insurance Legislation Amendment (Transparent Patient Outcomes) Bill 2021 will establish Transparent Patient Outcomes registers for a range of medical specialties such as plastic, reconstructive and orthopaedic surgery, which its proponents say will allow consumers to make informed choices after viewing the performance of individual practitioners and patient outcomes for procedures they are poised to undergo.

Speaking on 23 November, Senator Stirling Griff said the transparency register will include information such as the number and type of surgical procedures performed by a practitioner, their surgical revision rate, their patient mortality rate, any prosthesis device they may use, patient data and any other information deemed relevant to that specialty. This information would also be available at the facility level.

“Such a database would provide objective comparable statistics and would provide prospective patients factual information through which they could exercise greater self-determination in their choice of practitioner (rather than relying on trust, assurance or referrals) and the database could also serve to reassure an anxious patient,” he said.

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