Dr Peter McCullough: Assessing Heart Attack Risk After COVID-19 Vaccination (2024)

Rationale for Risk Stratification

We continue to observe COVID-19 vaccinated persons suffer cardiac arrests since the inception of the mass vaccination campaign in late 2020 [1–5]. Figure 1 illustrates the likely mechanisms. Both Pfizer-BioNTech (BNT162b2) and Moderna (mRNA-1273) mRNA have been found in human heart muscle at autopsy [6]. Spike protein has been stained in endomyocardial biopsy samples of young men suffering from COVID-19 vaccine-induced myocarditis [7]. Victims have been found to have circulating Spike protein but ineffective antibodies, likely IgG4 subclass, that fail to neutralize Spike protein and allow its assault on the heart [8]. Positron emission tomography data have revealed a shift from free fatty acid metabolism to glucose metabolism in the hearts of the majority of individuals who have received a COVID-19 vaccine. [9]. The PET pattern resembles global ischemia. This could be due to vaccine Spike protein hemagglutination in myocardial capillaries or cellular changes in mitochondrial respiration and substrate metabolism [10]. Small patches of dysfunctional, inflamed, or scarred myocardium are sufficient to serve as a nidus for re-entrant ventricular tachycardia that can degrade to ventricular fibrillation and lead to cardiac arrest [11]. A surge in catecholamines (epinephrine, norepinephrine, and dopamine) that can occur during sports or the waking hours of sleep (3 AM to 6 AM) may trigger reentrant ventricular tachycardia or spontaneous ventricular fibrillation leading to a cardiac arrest in patients with COVID-19 vaccine subclinical myocarditis [12].

Risk Stratification Approach

When patients are seen in clinical practice for the initial evaluation of cardiovascular symptoms following SARS-CoV-2 infection or vaccination, a proposed approach is outlined in Figure 2. COVID19 vaccine-induced myocarditis is caused principally by the Spike protein [7,8,16,24]. Measures of cytokine activation and inflammation are secondary to Spike protein resident in the myocardium and circulating in blood [7,8].

When risk stratification indicates low-risk, primary care office management is suggested with McCullough Protocol: Base Spike Detoxification and adjunctive medications depending on the syndrome (Figure 3) [25]. For subclinical myopericarditis, oral colchicine 0.6 mg BID (twice a day) or QD (once a day) is indicated for at least one year [45]. For COVID-19 vaccine-induced postural orthostatic tachycardia syndrome (POTS), use of colchicine and nadolol 20-40 mg BID can be helpful [46]. In patients who screen as high-risk, Base Spike Detoxification [25] is also indicated. For those at very high risk for cardiomyopathy and or ventricular arrhythmias, formal cardiology consultation is suggested with the main goals of preventing heart failure and sudden death. Additionally, some patients may require ICD implantation if there are symptomatic arrhythmias, LGE > 15%, or genetic predictors such as pathogenic SCN5A mutations [37,47].

Figure 3. McCullough Protocol: Base Spike Detoxification (BSD)

A: Dissolution of spike proteininduced thrombus. Nattokinase directly degrades fibrinolysis-resistant fibrin (from spike protein), and bromelain upregulates fibrinolysis. 

B: Inhibition of spike protein via ACE2 receptors. Bromelain and curcumin block the ACE2 receptor, preventing spike protein from binding. 

C: Proteolytic degradation of spike protein. Nattokinase and bromelain degrade spike proteins, rendering them inactive. 

D: Attenuation of spike protein-induced inflammation. Bromelain and curcumin downregulate the NF-kB signaling pathway induced by spike protein, leading to the suppression of inflammatory molecules. 

E: BSD treatment protocol. The full treatment regimen and the addition of other compounds based on clinical indication are illustrated. 

Abbreviations: TPA = tissue plasminogen activator, PAI-1 = plasminogen activator inhibitor-1, ACE2 = angiotensin converting enzyme-2, NF-kB = nuclear factor kappa B, S1/S2 = spike protein subunits S1/S2, TLR4 = toll-like receptor 4. *Figure and legend reprinted from Hulscher et al [25]. 

Autopsy Results in Fatal Cases of Heart Inflammation from COVID-19 Vaccines

The top National Library of Medicine PubMed study for COVID-19 Vaccine-Induced Myocarditis is currently Dr Peter McCullough's paper: 'Autopsy Findings in Cases of Fatal COVID-19 Vaccine-Induced Myocarditis', published in the European Society of Cardiology's journal (2024).

References 

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Source: https://www.preprints.org/manuscript/202408.0821/v1

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