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Influenza Vaccination as Prevention Therapy for Stable Coronary Artery Disease and Acute Coronary Syndrome: A
Letícia Mara Dos Santos Barbetta1, Eduardo Thadeu de Oliveira Correia1, Ronaldo Altenburg Odebrecht Curi Gismondi2
1Fluminense Federal University, Niterói, Rio de Janeiro, Brazil; Cardiovascular Disease Doctoral Program, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil.
Insights
Influenza vaccination significantly reduces mortality and major cardiovascular events in coronary artery disease patients, particularly those with acute coronary syndrome. This intervention offers a cost-effective way to improve outcomes for at-risk individuals.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- Influenza poses a significant health risk to patients with coronary artery disease (CAD).
- This meta-analysis evaluates the efficacy of influenza vaccination in individuals with acute coronary syndrome (ACS) and stable CAD.
Approach:
- Searched multiple databases (Cochrane, Embase, MEDLINE) and clinical trial registries up to September 2021.
- Included five randomized controlled trials with 4187 participants.
- Employed Mantel-Haenzel and random-effects models for data synthesis, using the I² statistic for heterogeneity assessment.
Key Points:
- Influenza vaccination demonstrated a significant reduction in all-cause mortality (RR 0.56), cardiovascular mortality (RR 0.54), major adverse cardiovascular events (RR 0.66), and ACS (RR 0.63).
- Subgroup analysis indicated effectiveness in ACS patients, but not statistically significant in stable CAD patients.
- No significant reduction was observed for revascularization, stroke/TIA, or heart failure hospitalization.
Conclusions:
- Influenza vaccination is a cost-effective intervention for reducing mortality and major adverse cardiovascular events in CAD patients.
- The protective effect is particularly pronounced in patients experiencing acute coronary syndrome.
- Vaccination represents a valuable strategy for managing cardiovascular risk in this vulnerable population.
Background:
Influenza can cause a significant burden on patients with coronary artery disease. This meta-analysis assessed the effectiveness of influenza vaccination in patients with acute coronary syndrome and stable coronary artery disease.
Methods:
We searched the Cochrane Controlled Register of Trials (CENTRAL), Embase, MEDLINE, www.
Clinicaltrials:
gov, and the World Health Organization International Clinical Trials Registry Platform from inception to September 2021. Estimates were summarized using the Mantel-Haenzel method and a random-effects model. To assess heterogeneity the I² statistic was used.
Results:
Five randomized trials, comprising 4187 patients, were included, 2 of which included patients with acute coronary syndrome and 3 that included patients with stable coronary artery disease and acute coronary syndrome. Influenza vaccination significantly reduced the risk for all-cause mortality (relative risk [RR] = 0.56; 95% confidence interval [CI], 0.38-0.84), cardiovascular mortality (RR = 0.54; 95% CI, 0.37-0.80), major acute cardiovascular events (RR = 0.66; 95% CI, 0.49-0.88), and acute coronary syndrome (RR = 0.63; 95% CI, 0.44-0.89). On subgroup analysis, influenza vaccination remained effective for these outcomes in acute coronary syndrome but did not meet statistical significance in coronary artery disease. Furthermore, influenza vaccination did not reduce the risk for revascularization (RR = 0.89; 95% CI, 0.54-1.45), stroke or transient ischemic attack (RR = 0.85; 95% CI, 0.31-2.32), or heart failure hospitalization (RR = 0.91; 95% CI, 0.21-4.00).
Conclusions:
Influenza vaccine is a cheap and effective intervention to reduce the risk for all-cause mortality, cardiovascular mortality, major acute cardiovascular events, and acute coronary syndrome among coronary artery disease patients, especially in those with acute coronary syndrome.
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