Influenza Vaccination in Patients With Chronic Heart Failure

Vardeny, Orly; Claggett, Brian; Udell, Jacob A.; Packer, Milton; Zile, Michael R.; Rouleau, Jean L.; Swedberg, Karl; Desai, Akshay S.; Lefkowitz, Martin; Shi, Victor; McMurray, John J.V.; Solomon, Scott D.

doi:10.1016/j.jchf.2015.10.012

Cited by 131 publications

(114 citation statements)

References 27 publications

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“…(39) This post-hoc analysis found influenza vaccination rates of 21% in the overall study cohort of over 8,000 participants across North and South America, Asia, and Europe. Vaccination rates in the United States were 55%, significantly higher than the study average, but over 20% lower than countries such as Great Britain, Netherlands, and Belgium.…”

Section: Respiratory Vaccination Rates In Hfmentioning

confidence: 88%

“…(39) In propensity adjusted models, the composite outcome of CV death and HF hospitalization did not reach statistical significance, though there was a signal toward clinical benefit in the vaccinated group. Perhaps limited long-term follow-up could explains these findings, as a cohort analysis of 1964 HF patients found no association with influenza vaccine and 1-year all cause mortality, but the relationship showed significant benefit in the vaccination group when 4-year mortality was used as the clinical endpoint.…”

Section: Influenza Vaccination In a Hf Populationmentioning

confidence: 98%

“…Vaccination rates in the United States were 55%, significantly higher than the study average, but over 20% lower than countries such as Great Britain, Netherlands, and Belgium. (39) Predictors of vaccination included older age, white race, and interestingly, lower NYHA functional class.…”

Section: Respiratory Vaccination Rates In Hfmentioning

confidence: 99%

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Can Vaccinations Improve Heart Failure Outcomes?

Bhatt

DeVore

Hernandez

et al. 2017

JACC: Heart Failure

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Heart failure (HF) is a chronic syndrome characterized by acute exacerbations. There is significant overlap between respiratory infections and exacerbation of underlying HF. Vaccination against respiratory infections in HF patients could serve as a potential cost-effective intervention to improve patients’ quality of life and clinical outcomes. The benefits of influenza vaccination in secondary prevention of ischemic heart disease have been previously studied. However, the evidence for influenza and pneumococcal vaccination specifically in the HF population is less well established. Furthermore, questions around the optimal timing, dose, frequency, and implementation strategies are largely unanswered. This review highlights the current evidence for vaccination against influenza and pneumococcal pneumonia in HF and cardiovascular disease in general. It summarizes current understanding of the pathophysiologic mechanisms in which vaccination may provide cardioprotection. Finally, it offers opportunities for further investigation of the effects of vaccination in the HF population, including basic science, translational research, and large clinical trials.

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Section: Respiratory Vaccination Rates In Hfmentioning

confidence: 88%

Section: Influenza Vaccination In a Hf Populationmentioning

confidence: 98%

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Can Vaccinations Improve Heart Failure Outcomes?

Bhatt

DeVore

Hernandez

et al. 2017

JACC: Heart Failure

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“…The post hoc analysis of the PARADIGM-HF Trial, demonstrated that influenza vaccination was associated with a lower risk for all-cause mortality (HR 0.81 [0.67–0.97], p = 0.015), whereas in propensity adjusted models, the composite outcome of CV death and HF hospitalization did not reach statistical significance [50]. Perhaps limited long-term follow-up could explain these findings.…”

Section: Heart Failurementioning

confidence: 99%

“…The post hoc analysis reported influenza vaccination rates of only 21% in the overall study cohort of over 8,000 participants and provided us with interesting data about the variation of influenza vaccination rates among HF patients across the world, being highest in the Netherlands (77.5%), Great Britain (77.2%) and Belgium (67.5%), intermediate in the United States (53%), 10–30% in countries as Slovakia, Brasil and Korea and less than 2% in China, Russia and India. Significant predictors of vaccination included older age and lower NYHA functional class [50]. …”

Section: Heart Failurementioning

confidence: 99%

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

et al. 2018

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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.

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Temporal Trends and Patterns in Mortality After Incident Heart Failure

et al. 2019

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IMPORTANCE Despite considerable improvements in heart failure care, mortality rates among patients in high-income countries have changed little since the early 2000s. Understanding the reasons underlying these trends may provide valuable clues for developing more targeted therapies and public health strategies. OBJECTIVE To investigate mortality rates following a new diagnosis of heart failure and examine changes over time and by cause of death and important patient features. DESIGN, SETTING, AND PARTICIPANTS This population-based retrospective cohort study analyzed anonymized electronic health records of individuals who received a new diagnosis of heart failure between January 2002 and December 2013 who were followed up until December 2014 from the Clinical Practice Research Datalink, which links information from primary care, secondary care, and the national death registry from a subset of the UK population. The data were analyzed from January 2018 to February 2019.MAIN OUTCOMES AND MEASURES All-cause and cause-specific mortality rates at 1 year following diagnosis. Poisson regression models were used to calculate rate ratios (RRs) and 95% confidence intervals comparing 2013 with 2002, adjusting for age, sex, region, socioeconomic status, and 17 major comorbidities. RESULTSOf 86 833 participants, 42 581 (49%) were women, 51 215 (88%) were white, and the mean (SD) age was 76.6 (12.6) years. While all-cause mortality rates declined only modestly over time (RR comparing 2013 with 2002, 0.94; 95% CI, 0.88-1.00), underlying patterns presented explicit trends. A decline in cardiovascular mortality (RR, 0.73; 95% CI, 0.67-0.80) was offset by an increase in noncardiovascular deaths (RR, 1.22; 95% CI, 1.11-1.33). Subgroup analyses further showed that overall mortality rates declined among patients younger than 80 years (RR, 0.79; 95% CI, 0.71-0.88) but not among those older than 80 years (RR, 0.97; 95% CI, 0.90-1.06). After cardiovascular causes (898 [43%]), the major causes of death in 2013 were neoplasms (311 [15%]), respiratory conditions (243 [12%]), and infections (13%), the latter 2 explaining most of the observed increase in noncardiovascular mortality. CONCLUSIONS AND RELEVANCE Among patients with a new heart failure diagnosis, considerable progress has been achieved in reducing mortality in young and middle-aged patients and cardiovascular mortality across all age groups. Improvements to overall mortality are hindered by high and increasing rates of noncardiovascular events. These findings challenge current research priorities and management strategies and call for a greater emphasis on associated comorbidities. Specifically, infection prevention presents as a major opportunity to improve prognosis.

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Influenza Vaccination in Patients With Chronic Heart Failure

Abstract: Background Influenza is associated with an increased risk for cardiovascular events in patients

Cited by 131 publications

References 27 publications

Can Vaccinations Improve Heart Failure Outcomes?

Can Vaccinations Improve Heart Failure Outcomes?

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

Temporal Trends and Patterns in Mortality After Incident Heart Failure

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