Absence of Platelet Overactivation and Hypercoagulability Among Patients with Coronary Atherosclerosis Disease after Vaccination Against SARS-CoV-2

Background: Association of Coronavirus disease 2019 vaccines with thrombosis has raised concerns among patients with coronary atherosclerosis disease (CAD).ObjectivesTo detect platelet activation, coagulation, the profile of prothrombotic antibodies, and the production of platelet factor 4 (PF4) antibodies in patients with CAD.Methods: Inpatients undergoing percutaneous coronary intervention (PCI) were consecutively enrolled in this cross-sectional study. Two groups were defined according to vaccination status. We evaluated platelet parameters, coagulation by thrombelastograph, platelet activation makers (PAC-1 and P-selectin) by flow cytometry, PF4 antibody and antiphospholipid antibodies by ELISA, and SARS-CoV-2 neutralizing antibody. Adverse reactions after vaccination were recorded.Results: A total of 182 patients with CAD were included in the final analysis, of whom 92 had been vaccinated. Baseline characteristics were well balanced between unvaccinated and vaccinated groups. There were no differences in platelet parameters or coagulation state (coagulation functions and TEG parameters) between the groups. The expression of PAC-1 (225.0 (156.0-323.0) vs 197.0 (68.25-282.0), P = 0.070) and P-selectin (281 (233.0-409.0) vs 256.0 (238.0-305.5), P = 0.083), the prevalence of positivity for PF4 antibodies (2.2% vs 4.4%, P = 0.682) and antiphospholipid antibodies were similar between these two groups. In the vaccinated group, 68.5% of the samples tested positive. No grade 3 adverse reactions after vaccination were recorded.Conclusions: Among CAD patients receiving PCI, inactivated SARS-CoV-2 vaccines did not enhance platelet activation, cause hypercoagulability, or tiger the production of PF4 and antiphospholipid antibodies. Our data adds evidence to the safety profile of the inactivated SARS-CoV-2 vaccines.