Eur J Prev Cardiol . Cardioprotective effects of Influenza Vaccination among Patients with Established Cardiovascular Disease or at High Cardiovascular Risk: A Systematic Review and Meta-analysis

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Eur J Prev Cardiol


. 2022 Jul 20;zwac152.
doi: 10.1093/eurjpc/zwac152. Online ahead of print.
Cardioprotective effects of Influenza Vaccination among Patients with Established Cardiovascular Disease or at High Cardiovascular Risk: A Systematic Review and Meta-analysis


Vikash Jaiswal ¹ , Song Peng Ang ² , Sadia Yaqoob ³ , Angela Ishak ^{1 4} , Jia Ec Chia ⁵ , Yusra Minahil Nasir ⁶ , Zauraiz Anjum ⁷ , M Chadi Alraies ⁸ , Akash Jaiswal ⁹ , Monodeep Biswas ¹⁰



Affiliations

• PMID: 35857821
• DOI: 10.1093/eurjpc/zwac152

Abstract

Background: The clinical impact of the influenza vaccination on cardiovascular outcomes in people with established cardiovascular disease (CVD) is still debated.
Aim: The aim of this meta-analysis was to estimate the effect of influenza vaccination on cardiovascular and cerebrovascular outcomes among patients with established CVD.
Methods: We systematically searched all electronic databases from inception until 15 April 2022. Primary clinical outcomes were all-cause mortality (ACM), and major adverse clinical events (MACE). Secondary endpoints were heart failure, myocardial infarction, CV mortality, and stroke.
Results: Eighteen articles (five randomized trials and thirteen observational studies), with a total of 22,532,165 patients were included in the analysis. There were 217,072 participants included in the high cardiovascular risk or established CVD population (vaccinated n = 111,073 and unvaccinated n = 105,999). The mean age of the patients was 68 years old, without any difference between groups (69 vs 71) years. At mean follow-up of 1.5 years, vaccinated group was associated with lower risk for all-cause mortality [HR, 0.71(95%CI, 0.63-0.80), p < 0.001], MACE [HR, 0.83(95%CI:0.72-0.96), p = 0.01], CV mortality [HR, 0.78(95%CI:0.68-0.90), p < 0.001] and myocardial infarction [HR, 0.82(95%CI:0.74-0.92), p < 0.001] compared to unvaccinated group. While incidence of stroke [HR, 1.03 (95%CI, 0.92-1.06), p = 0.61] and heart failure [HR, 0.74 (95%CI, 0.51-1.08), p = 0.12] did not differ between the two groups.
Conclusion: Influenza vaccination reduced major adverse clinical events, all-cause mortality, CV mortality and myocardial infarction. These highlighted the importance of influenza vaccination in established CVD or high cardiovascular risk.

Keywords: Acute Coronary Syndrome; Epidemiology; Heart Failure; Influenza Vaccines.