Influenza vaccination and cardiovascular events in patients with ischaemic heart disease and heart failure: A meta‐analysis

Abstract

AimRandomized controlled trials (RCTs) enrolling patients at 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 ischaemic heart disease or heart failure.Methods and resultsWe 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 ischaemic heart disease or heart failure. Eligible studies followed patients for at least one influenza season, defined as a minimum duration of 6 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. We included five peer‐reviewed and one non peer‐reviewed RCTs for a total of 9340 patients. Five trials included patients with ischaemic 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 HR [rHR] 0.74, 95% confidence interval [CI] 0.63–0.88, p < 0.001, I2 = 52%), cardiovascular death (rHR 0.63, 95% CI 0.42–0.95, p = 0.028, I2 = 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.ConclusionIn 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.

Hospital disease burden due to influenza and its comorbidities in Spain (2016-2021)

“…Asimismo, en un estudio trasversal realizado en hospitales centinelas en Cataluña durante las temporadas gripales 2018-2020 se observó que el nivel de ingresos en UCI fue significativamente mayor en los casos no vacunados en comparación con los vacunados y, por consiguiente, la vacuna contra la influenza reduce los costes de hospitalización (22). También es de interés destacar que en ensayos clínicos realizados en pacientes de alto riesgo cardiovascular la vacunación antigripal ha demostrado reducir los eventos cardiovasculares, mortalidad cardiovascular y la mortalidad en comparación con placebo (23,24). Además, es importante destacar que, entre las indicaciones de vacunación antigripal aprobadas por el Ministerio de Sanidad del Gobierno de España el 12 de septiembre de 2023 para la temporada 2023-2024, se encuentran, en el grupo 3, aquellas personas menores de 60 años, con condiciones de riesgo como son la diabetes mellitus, síndrome de Cushing, obesidad mórbida, enfermedades crónicas cardiovasculares, neurológicas o respiratorias; así como otras muchas comorbilidades.…”

RNAseq of INOCA patients identifies innate, invariant, and acquired immune changes: potential autoimmune microvascular dysfunction

“…Large studies have demonstrated a temporal association between influenza infection and myocardial infarction ( 42 ). Likewise, flu vaccines have a provable benefit in randomized control trials at preventing adverse events in high-risk CV patients ( 43 ).…”

September 2023 at a glance: focus on acute heart failure and health status

“…50 A meta-analysis including 9340 patients from five RCTs showed that influenza vaccination was associated with reduced incidence of CV events, CV death and all-cause death as compared to placebo or no treatment in patients with ischaemic heart disease and HF. 51…”