Can Vaccinations Improve Heart Failure Outcomes?

Bhatt, Ankeet S.; DeVore, Adam D.; Hernandez, Adrian F.; Mentz, Robert J.

doi:10.1016/j.jchf.2016.12.007

Cited by 48 publications

(29 citation statements)

References 60 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It has been suggested that some antibodies elicited by influenza vaccines act as agonists, which activate a bradykinin 2 receptor-associated signalling pathway contributing to the protection against CVD [59]. Pneumococcal vaccination leads to the production of IgM antibodies that share binding sites with anti-oxidized LDL antibodies [60]. In murine models, this molecular mimicry may slow the macrophage uptake of oxidized LDL, a process of foam cell and plaque formation [61, 62].…”

Section: Potential Cardiovascular Protective Mechanisms Of Influenza mentioning

confidence: 99%

“…Respiratory infection-induced inflammatory process may also impair inotropy [60]. The production of TNF-α and interleukin-1 beta during acute illness can independently depress myocyte contractility [63, 64].…”

Section: Potential Cardiovascular Protective Mechanisms Of Influenza mentioning

confidence: 99%

“…The production of TNF-α and interleukin-1 beta during acute illness can independently depress myocyte contractility [63, 64]. Moreover, sustained cytokine expression can lead to adverse myocardial remodelling and excess production of tissue inhibitors of matrix metalloproteinases [60]. These mechanisms have been associated with left ventricular dilatation and increases in myocardial collagen content, contributing to the HF phenotype [60].…”

Section: Potential Cardiovascular Protective Mechanisms Of Influenza mentioning

confidence: 99%

“…Moreover, sustained cytokine expression can lead to adverse myocardial remodelling and excess production of tissue inhibitors of matrix metalloproteinases [60]. These mechanisms have been associated with left ventricular dilatation and increases in myocardial collagen content, contributing to the HF phenotype [60]. Infection-related changes in cardio-renal function may exaggerate fluids shift, leading to volume overload and subsequently HF manifestation or decompensation [65].…”

Section: Potential Cardiovascular Protective Mechanisms Of Influenza mentioning

confidence: 99%

“…A direct link between vaccination-related attenuation in inflammation and atherosclerosis and the HF phenotype has not been yet firmly proved, though it would be assumed to reduce the progression of ischemic cardiomyopathy [60]. Further investigation is needed to shed light to the distinct effects of vaccination in those with ischemic versus non-ischemic cardiomyopathy [60]. …”

Section: Potential Cardiovascular Protective Mechanisms Of Influenza mentioning

confidence: 99%

See 4 more Smart Citations

Beneficial Effects of Vaccination on Cardiovascular Events: Myocardial Infarction, Stroke, Heart Failure

et al. 2018

View full text Add to dashboard Cite

Influenza and pneumococcal infections have been suggested to be potential risk factors for causing adverse cardiovascular events, especially in high-risk patients. Vaccination against respiratory infections in patients with established cardiovascular disease (CVD) could serve as a potential cost-effective intervention to improve their clinical outcomes and cardiac societies have encouraged it. Previous studies have shown that influenza vaccination reduce mortality, acute coronary syndromes and hospitalization in patients with coronary heart disease (CHD) and/or heart failure (HF). However, there is a paucity of randomized prospective clinical trials in the field of the pneumococcal vaccination, and additional higher-quality evidence is needed. Furthermore, questions around the role of vaccination in the primary prevention of CVD, the optimal dose and timing are largely unanswered. The pathophysiologic mechanism in which vaccination provides cardiovascular protection may be related to the modification of the immune-inflammatory model of atherogenesis. The present review summarizes the current evidence and understanding for vaccination against influenza and streptococcus pneumoniae in CHD, HF and stroke and highlights its beneficial effect in the reduction of adverse cardiovascular events.

show abstract

Section: Potential Cardiovascular Protective Mechanisms Of Influenza mentioning

confidence: 99%

Section: Potential Cardiovascular Protective Mechanisms Of Influenza mentioning

confidence: 99%

Section: Potential Cardiovascular Protective Mechanisms Of Influenza mentioning

confidence: 99%

Section: Potential Cardiovascular Protective Mechanisms Of Influenza mentioning

confidence: 99%

Section: Potential Cardiovascular Protective Mechanisms Of Influenza mentioning

confidence: 99%

See 3 more Smart Citations

Beneficial Effects of Vaccination on Cardiovascular Events: Myocardial Infarction, Stroke, Heart Failure

et al. 2018

View full text Add to dashboard Cite

show abstract

Electronic Nudges and Influenza Vaccination Among Patients With a History of Myocardial Infarction

Bhatt,

Johansen,

Vaduganathan

et al. 2024

JAMA Cardiol

View full text Add to dashboard Cite

ImportanceInfluenza vaccination in patients with acute myocardial infarction (AMI) reduces major adverse cardiac events and is strongly recommended in clinical practice guidelines. Effective strategies to improve vaccination are needed in these high-risk patients.ObjectiveTo evaluate whether electronically delivered behavioral nudges improve influenza vaccine uptake in patients with AMI across 3 nationwide implementation randomized clinical trials (RCTs).Design, Setting, and ParticipantsNationwide Utilization of Danish Government Electronic Letter System for Increasing Influenza Vaccine Uptake (NUDGE-FLU), Nationwide Utilization of Danish Government Electronic Letter System for Confirming the Effectiveness of Behavioral Nudges in Increasing Influenza Vaccine Uptake Among Older Adults (NUDGE-FLU-2), and Nationwide Utilization of Danish Government Electronic Letter System for Increasing Influenza Vaccine Uptake Among Adults With Chronic Disease (NUDGE-FLU-CHRONIC) were RCTs conducted during the 2022 to 2023 and 2023 to 2024 influenza seasons in Denmark. Participants were randomized to either usual care or various behaviorally informed, electronically delivered, letter-based nudges. In a prespecified participant-level pooled meta-analysis, interaction of AMI status on the effects of letter-based nudges vs usual care was examined. Pooled treatment effects were estimated using binomial regression models with identity link, adjustment for trial, and 2-way clustered SEs at the household and participant levels. Effect modification by recency of AMI as a continuous variable was assessed using restricted cubic spline modeling in NUDGE-FLU-CHRONIC.InterventionsBehaviorally informed, electronically delivered, letter-based nudges or usual care.Main Outcome and MeasuresThe primary end point was influenza vaccination receipt.ResultsOf 2 146 124 individual randomizations (mean [SD] age, 71.1 [11.6] years; 1 114 725 female [51.9%]) across all 3 trials, 59 458 (2.8%) had a history of AMI. Improvement in vaccine uptake was similar in patients with vs without a history of AMI who received any nudge letter compared with usual care (+1.81 vs +1.32 percentage points; P for interaction by AMI status = .09). A letter highlighting the cardiovascular benefits of vaccination (ie, cardiovascular-gain frame) resulted in larger improvements in vaccine uptake among patients with (vs without) a history of AMI (+3.91 vs +2.03 percentage points; P for interaction by AMI status = .002). Among patients with AMI, the benefits of the cardiovascular-gain frame letter were more pronounced in those not vaccinated in the prior season (+13.7 vs +1.48 percentage points; P for interaction &lt;.001). Among younger participants with chronic disease, the cardiovascular-gain frame letter was particularly effective in patients with more recent AMI (P for interaction by continuous recency of AMI &lt;.001).Conclusions and RelevanceAcross 3 nationwide RCTs of Danish citizens, messaging emphasizing the cardiovascular benefits of vaccination improved influenza vaccination uptake, with greater benefits observed in patients with a history of AMI. This low-cost, scalable implementation strategy should be considered to encourage influenza vaccination in high-risk patients.Trial RegistrationClinicalTrials.gov Identifiers: NCT05542004, NCT06030726, NCT06030739

show abstract

Vaccine‐preventable disease hospitalized patients with heart failure with reduced ejection fraction

Fratti

Salazar

Argueta-Sosa

2022

Clinical Cardiology

View full text Add to dashboard Cite

Background Over five million Americans suffer from heart failure (HF), and this is associated with multiple chronic comorbidities and recurrent decompensation. Currently, there is an increased incidence in vaccine‐preventable diseases (VPDs). We aim to investigate the impact of HF with reduced ejection fraction (HFrEF) in patients hospitalized with VPDs. Hypothesis Patient with HFrEF are at higher risk for VPDs and they carry a higher risk for in‐hospital complications. Methods Retrospective analysis from all hospital admissions from the 2016‐2018 National Inpatient Sample (NIS) using the ICD‐10CM codes for patients admitted with a primary diagnosis of VPDs with HFrEF and those without reduced ejection fraction. Outcomes evaluated were in‐hospital mortality, length of stay (LOS), healthcare utilization, frequency of admissions, and in‐hospital complications. Multivariate regression analysis was conducted to adjust for confounders. Results Out of 317 670 VPDs discharges, we identified 12 130 (3.8%) patients with HFrEF as a comorbidity. The most common admission diagnosis for VPDs was influenza virus (IV) infection (75.0% vs. 64.1%; p < .01), followed by pneumococcal pneumonia (PNA) (13% vs. 9.4%; p < .01). After adjusting for confounders, patients with HFrEF had higher odds of having diagnosis of IV (adjusted [aOR], 1.42; p < .01) and PNA (aOR, 1.27; p < .01). Patients with VPDs and HFrEF had significantly higher odds of mortality (aOR, 1.76; p < .01), LOS, respiratory failure requiring mechanical ventilation, and mechanical ventilation for less than 96 h. Conclusion Influenza and PNA were the most common VPDs admitted to the hospital in patients with a concomitant diagnosis of HFrEF. They were associated with increased mortality and in‐hospital complications.

show abstract

Can Vaccinations Improve Heart Failure Outcomes?

Cited by 48 publications

References 60 publications

Beneficial Effects of Vaccination on Cardiovascular Events: Myocardial Infarction, Stroke, Heart Failure

Beneficial Effects of Vaccination on Cardiovascular Events: Myocardial Infarction, Stroke, Heart Failure

Electronic Nudges and Influenza Vaccination Among Patients With a History of Myocardial Infarction

Vaccine‐preventable disease hospitalized patients with heart failure with reduced ejection fraction

Contact Info

Product

Resources

About