BACKGROUND Moderate alcohol consumption has been associated with lower risk of coronary heart disease death, but heavy alcohol consumption may increase risk. OBJECTIVE We sought to determine the association of alcohol‐related diagnoses with in‐hospital mortality in patients with acute myocardial infarction (AMI). DESIGN/SETTING/PATIENTS Discharge data collected from all admissions recorded in the Nationwide Inpatient Sample (NIS) database from 2011. A cross‐sectional analysis was performed using regression methods appropriate for the NIS sample design. MEASURES The outcome measures were in‐hospital mortality, length of stay, and cardiac procedures. RESULTS AMI accounted for 610,963 (1.9%) of adult in‐patient admissions, with an in‐hospital mortality rate of 5.3%. Alcohol‐related diagnoses were associated with increased mortality in AMI patients after controlling for factors associated with alcoholism including age, sex, liver disease, hypertension, diabetes, renal failure, peripheral vascular disease, arrhythmias, drug abuse, gastrointestinal bleed, and smoking (adjusted odds ratio [OR]: 1.5, 95% confidence interval [CI]: 1.2‐1.7, P < 0.001). This association was significant in both ST‐elevation myocardial infarction patients (adjusted OR: 1.7, 95% CI: 1.4‐2.2, P < 0.001) and non–ST‐elevation myocardial infarction patients (adjusted OR: 1.3, 95% CI: 1.0‐1.7, P = 0.025). Chronic alcohol‐related diagnoses were significantly associated with death, but acute alcohol effects (as estimated by withdrawal and intoxication) were not associated. CONCLUSION Chronic alcohol‐related diagnoses were associated with a modest increase in the risk for death in individuals presenting with AMI. This risk was not accounted for by common alcohol‐related comorbidities. As a component of global efforts to limit hospital deaths from AMI, future research should identify the factors underlying this association. Journal of Hospital Medicine 2016;11:563–567. © 2016 Society of Hospital Medicine

Cardiovascular disease (CVD) is the leading cause of death in the world and is largely preventable. An increasing amount of evidence suggests that annual influenza vaccination reduces CVD-related morbidity and mortality. Despite various clinical guidelines recommending annual influenza vaccination for the general population for influenza-like illness risk reduction, with a particular emphasis on people with CVD, vaccination rates fall consistently below the goal established by the World Health Organization. This review outlines the importance of influenza vaccination, mechanisms of cardiovascular events in influenza, summarizing the available literature on the effects of influenza vaccine in CVD and the benefits of influenza vaccine during the COVID-19 pandemic.

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Background: Moderate alcohol consumption is associated with lower risk of peripheral vascular disease (PVD). However, in heavy drinkers the evidence is limited, and there is little data on the effects of heavy drinking in patients admitted with PVD. We sought to investigate the prevalence and association of alcohol-related diagnoses with in-hospital mortality in patients presenting with PVD. Methods: We performed a cross-sectional analysis of the 2011 Nationwide Inpatient Sample (NIS). Using logistic regression methods appropriate for the NIS sample design, we estimated mortality associated with alcohol-related diagnoses in PVD patients and evaluated factors that might modify the association between alcohol and death. Results: PVD accounted for 158,683 (0.5%) of adult in-patient admissions with an in-hospital mortality rate of 4.6%. Of PVD admissions, a total of 4089 (2.6%) had concomitant alcohol-related diagnosis. Alcohol-related diagnoses were associated with increased mortality in PAD patients after controlling for factors associated with alcoholism, including age, sex, liver disease, hypertension, diabetes, renal failure, arrhythmias, drug abuse, gastro-intestinal bleed, and smoking [adjusted-odds ratio 1.7; 95% CI (1.3 - 2.4); P-value lt 0.001]. None of the factors included in the regression analyses interacted with alcohol abuse in predicting mortality, possibly due to lack of power. Conclusion: Alcohol-related diagnoses were associated with a modest increase in the risk for death in individuals presenting with PAD. This risk was not accounted for by common alcohol-related comorbidities. As a component of global efforts to limit hospital deaths from PAD, future research should identify the factors underlying this association.