tetano
Editor, Senior Moderator
Eur J Heart Fail
. 2023 Jun 27.
doi: 10.1002/ejhf.2945. Online ahead of print. Influenza vaccination and cardiovascular events in patients with ischaemic heart disease and heart failure: A meta-analysis
Daniel Modin[SUP] 1 [/SUP], Mats Christian Højbjerg Lassen[SUP] 1 [/SUP], Brian Claggett[SUP] 2 [/SUP], Niklas Dyrby Johansen[SUP] 1 [/SUP], Maryam Keshtkar-Jahromi[SUP] 3 [/SUP], Kristoffer Grundtvig Skaarup[SUP] 1 [/SUP], Joshua Nealon[SUP] 4 [/SUP], Jacob A Udell[SUP] 5 [/SUP], Orly Vardeny[SUP] 6 [/SUP], Scott D Solomon[SUP] 2 [/SUP], Gunnar Gislason[SUP] 1 7 [/SUP], Tor Biering-Sørensen[SUP] 1 8 [/SUP]
Affiliations
Background: Randomized controlled trials (RCTs) enrolling patients with high cardiovascular risk have found that influenza vaccination may reduce the incidence of cardiovascular events. We performed an updated meta-analysis assessing the effect of influenza vaccination on the incidence of cardiovascular events in patients with ischemic heart disease or heart failure.
Methods: We searched PubMed, EMBASE and other sources to identify RCTs examining the effect of influenza vaccination on the incidence of cardiovascular events assessed as efficacy outcomes in patients with ischemic heart disease or heart failure. Eligible studies followed patients for at least one influenza season, defined as a minimum duration of six months. The primary endpoint was a composite of cardiovascular death, acute coronary syndrome, stent thrombosis or coronary revascularization, stroke or heart failure hospitalization. The secondary endpoints were cardiovascular death and all-cause death. Two investigators independently identified and extracted data from studies. Results were compared using hazard ratios (HRs) in both random effects and fixed effects models.
Results: We included five peer-reviewed and one non peer-reviewed RCTs for a total of 9340 patients. Five trials included patients with ischemic heart disease (N=4211) and one trial included patients with heart failure (N=5129). Influenza vaccination was associated with a reduced incidence of the primary composite endpoint (Random effects hazard ratio (rHR) 0.74, 95% CI 0.63-0.88, p<0.001, I2=52%), cardiovascular death (rHR 0.63, 95% CI 0.42-0.95, p=0.028, I[SUP]2[/SUP] =58%) and all-cause death (rHR 0.72, 95% CI 0.54-0.95, p=0.0227, I2=52%). Results were similar when non peer-reviewed data were excluded.
Conclusion: In this meta-analysis of available RCTs in patients at high cardiovascular risk, influenza vaccination was associated with a reduced incidence of cardiovascular events, cardiovascular death and all-cause death as compared to placebo or no treatment.
. 2023 Jun 27.
doi: 10.1002/ejhf.2945. Online ahead of print. Influenza vaccination and cardiovascular events in patients with ischaemic heart disease and heart failure: A meta-analysis
Daniel Modin[SUP] 1 [/SUP], Mats Christian Højbjerg Lassen[SUP] 1 [/SUP], Brian Claggett[SUP] 2 [/SUP], Niklas Dyrby Johansen[SUP] 1 [/SUP], Maryam Keshtkar-Jahromi[SUP] 3 [/SUP], Kristoffer Grundtvig Skaarup[SUP] 1 [/SUP], Joshua Nealon[SUP] 4 [/SUP], Jacob A Udell[SUP] 5 [/SUP], Orly Vardeny[SUP] 6 [/SUP], Scott D Solomon[SUP] 2 [/SUP], Gunnar Gislason[SUP] 1 7 [/SUP], Tor Biering-Sørensen[SUP] 1 8 [/SUP]
Affiliations
- PMID: 37370193
- DOI: 10.1002/ejhf.2945
Background: Randomized controlled trials (RCTs) enrolling patients with high cardiovascular risk have found that influenza vaccination may reduce the incidence of cardiovascular events. We performed an updated meta-analysis assessing the effect of influenza vaccination on the incidence of cardiovascular events in patients with ischemic heart disease or heart failure.
Methods: We searched PubMed, EMBASE and other sources to identify RCTs examining the effect of influenza vaccination on the incidence of cardiovascular events assessed as efficacy outcomes in patients with ischemic heart disease or heart failure. Eligible studies followed patients for at least one influenza season, defined as a minimum duration of six months. The primary endpoint was a composite of cardiovascular death, acute coronary syndrome, stent thrombosis or coronary revascularization, stroke or heart failure hospitalization. The secondary endpoints were cardiovascular death and all-cause death. Two investigators independently identified and extracted data from studies. Results were compared using hazard ratios (HRs) in both random effects and fixed effects models.
Results: We included five peer-reviewed and one non peer-reviewed RCTs for a total of 9340 patients. Five trials included patients with ischemic heart disease (N=4211) and one trial included patients with heart failure (N=5129). Influenza vaccination was associated with a reduced incidence of the primary composite endpoint (Random effects hazard ratio (rHR) 0.74, 95% CI 0.63-0.88, p<0.001, I2=52%), cardiovascular death (rHR 0.63, 95% CI 0.42-0.95, p=0.028, I[SUP]2[/SUP] =58%) and all-cause death (rHR 0.72, 95% CI 0.54-0.95, p=0.0227, I2=52%). Results were similar when non peer-reviewed data were excluded.
Conclusion: In this meta-analysis of available RCTs in patients at high cardiovascular risk, influenza vaccination was associated with a reduced incidence of cardiovascular events, cardiovascular death and all-cause death as compared to placebo or no treatment.