Influenza vaccination might reduce the risk of ischemic stroke in patients with atrial fibrillation: A population-based cohort study

Kao, Pai Feng; Liu, Ju Chi; Hsu, Yi Ping; Sung, Li Chin; Yang, Tien-Shuh; Hao, Wen Rui; Lin, Ying; Wu, Szu‐Yuan

doi:10.18632/oncotarget.22352

Cited by 20 publications

(20 citation statements)

References 49 publications

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“…23 A follow up study from the same research group has also suggested influenza vaccination may be effective in reducing the risk of ischemic stroke in patients aged greater than 65 years with atrial fibrillation. 45 Our study has some limitations. This study was conducted using the DMSS administrative database and we were unable to access medical records to validate the diagnosis of atrial fibrillation (e.g., using EKG) and to determine more accurately its onset in relation to specific vaccinations.…”

Section: Discussionmentioning

confidence: 89%

Vaccination and risk of lone atrial fibrillation in the active component United States military

McNeil

Duderstadt

Sabatier

et al. 2019

Human Vaccines & Immunotherapeutics

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Purpose: To evaluate the hypothesis that receipt of anthrax vaccine adsorbed (AVA) increases the risk of atrial fibrillation in the absence of identifiable underlying risk factors or structural heart disease (lone atrial fibrillation). Methods: We conducted a retrospective population-based cohort study among U.S. military personnel who were on active duty during the period from January 1, 1998 through December 31, 2006. International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes were used to identify individuals diagnosed with atrial fibrillation in the Defense Medical Surveillance System, and electronic records were screened to include only individuals without evidence of predisposing medical conditions. We used multivariable Poisson regression to estimate the risk of lone atrial fibrillation after exposure to AVA. We also evaluated possible associations with influenza and smallpox vaccines. Results: Our study population consisted of 2,957,091individuals followed for 11,329,746 person-years of service. Of these, 2,435 met our case definition for lone atrial fibrillation, contributing approximately 8,383 person-years of service. 1,062,176 (36%) individuals received at least one dose of AVA; the median person time observed post-exposure was 3.6 years. We found no elevated risk of diagnosed lone atrial fibrillation associated with AVA (adjusted risk ratio = 0.99; 95% confidence interval = 0.90, 1.09; p = 0.84). No elevated risk was observed for lone atrial fibrillation associated with influenza or smallpox vaccines given during military service. Conclusions: We did not find an increased risk of lone atrial fibrillation after AVA, influenza or smallpox vaccine. These findings may be helpful in planning future vaccine safety research.

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Section: Discussionmentioning

confidence: 89%

Vaccination and risk of lone atrial fibrillation in the active component United States military

McNeil

Duderstadt

Sabatier

et al. 2019

Human Vaccines & Immunotherapeutics

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“…Patients with hypertension (HTN), diabetes, and AF have an increased risk of complications associated with influenza. The mostly observational studies done to date have shown a protective effect of IV for these three populations, but due to the limitations of the studies, it is not possible to establish strong recommendations [ 53 54 55 ].…”

Section: Resultsmentioning

confidence: 99%

Influenza Vaccination for the Prevention of Cardiovascular Disease in the Americas: Consensus document of the Inter-American Society of Cardiology and the Word Heart Federation

Liprandi

Zaidel

et al. 2021

Global Heart

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Background: Cardiovascular mortality is decreasing but remains the leading cause of death world-wide. Respiratory infections such as influenza significantly contribute to morbidity and mortality in patients with cardiovascular disease. Despite of proven benefits, influenza vaccination is not fully implemented, especially in Latin America. Objective: The aim was to develop a regional consensus with recommendations regarding influenza vaccination and cardiovascular disease. Methods: A multidisciplinary team composed by experts in the management and prevention of cardiovascular disease from the Americas, convened by the Inter-American Society of Cardiology (IASC) and the World Heart Federation (WHF), participated in the process and the formulation of statements. The modified RAND/UCLA methodology was used. This document was supported by a grant from the WHF. Results: An extensive literature search was divided into seven questions, and a total of 23 conclusions and 29 recommendations were achieved. There was no disagreement among experts in the conclusions or recommendations. Conclusions: There is a strong correlation between influenza and cardiovascular events. Influenza vaccination is not only safe and a proven strategy to reduce cardiovascular events, but it is also cost saving. We found several barriers for its global implementation and potential strategies to overcome them.

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“…To our knowledge, the present study is the first population-based study to demonstrate that the protective effect of influenza vaccine in reducing all-cause mortality, influenza-related hospitalization, LOS, and medical expenditure in elderly individuals with disability. Medical expenditure of individuals with influenza, including those with influenza-related complications such as pneumonia [24], respiratory diseases [25], respiratory failure [26,27], heart disease [28][29][30], hemorrhagic stroke [31], and ischemic stroke [30], has often led to higher spending. In our study, we found that influenza vaccination was associated with reductions in all-cause mortality, influenza-related hospitalization, LOS, and medical costs decreased among elderly individuals with a disability (Tables 1 and 2).…”

Section: Discussionmentioning

confidence: 99%

Protective Effect of Seasonal Influenza Vaccination in Elderly Individuals with Disability in Taiwan: A Propensity Score–Matched, Nationwide, Population-Based Cohort Study

et al. 2020

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This is the first and largest population-based cohort study to demonstrate that influenza vaccination reduced all-cause mortality and influenza-related hospitalization in elderly individuals with a disability. Purpose: To estimate the protective effect of influenza vaccination in elderly individuals with a disability by conducting a propensity score-matched (PSM), nationwide, population-based cohort study. Methods: Data from Taiwan’s National Health Insurance Research Database were used in this study. Generalized estimating equations (GEEs) were used to compare outcomes between the vaccinated and unvaccinated cohorts. The GEE logit was used to estimate the relative risks of death and hospitalization after influenza vaccination. Adjusted odds ratios (aORs) were used to estimate relative risk. Results: The matching process yielded a final cohort of 272 896 elderly individuals with a disability (136 448 individuals in each cohort). In multivariate GEE analyses, aOR (vaccinated vs. unvaccinated) and 95% confidence interval (CI) of death were 0.70 (0.68–0.72). The aORs (95% CIs) of hospitalization for influenza and pneumonia, respiratory diseases, respiratory failure, heart disease, hemorrhagic stroke, and ischemic stroke were 0.98 (0.95–1.01), 0.96 (0.94–0.99), 0.85 (0.82–0.89), 0.96 (0.93–0.99), 0.85 (0.75–0.97), and 0.89 (0.84–0.95), respectively. The length of stay and medical expenditure exhibited greater reduction in vaccinated elderly individuals with a severe and very severe disability than in unvaccinated elderly individuals. Conclusions: Influenza vaccination reduced all-cause mortality, influenza-related hospitalization, length of stay, and medical expenditure in elderly individuals with a disability. The decrease in the length of stay and medical expenditure because of influenza vaccination was proportional to the severity of disability.

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Influenza vaccination might reduce the risk of ischemic stroke in patients with atrial fibrillation: A population-based cohort study

Cited by 20 publications

References 49 publications

Vaccination and risk of lone atrial fibrillation in the active component United States military

Vaccination and risk of lone atrial fibrillation in the active component United States military

Influenza Vaccination for the Prevention of Cardiovascular Disease in the Americas: Consensus document of the Inter-American Society of Cardiology and the Word Heart Federation

Protective Effect of Seasonal Influenza Vaccination in Elderly Individuals with Disability in Taiwan: A Propensity Score–Matched, Nationwide, Population-Based Cohort Study

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