Influenza vaccination reduces cardiovascular events in patients with acute coronary syndrome

Phrommintikul, Arintaya; Kuanprasert, Srun; Wongcharoen, Wanwarang; Kanjanavanit, Rungsrit; Chaiwarith, Romanee; Sukonthasarn, Apichard

doi:10.1093/eurheartj/ehr004

Cited by 195 publications

(157 citation statements)

References 25 publications

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“…[258] A recent study with similar methods among patients with acute coronary syndrome looked at a broader outcome of combined major cardiovascular events and found a significant hazards ratio of 0.70, but found no significant difference in cardiovascular deaths between the vaccine and control groups. [259] A 2008 Cochrane review of vaccine effects on patients with coronary heart disease included 2 trials and concluded that the small numbers of outcomes of interest, such as cardiovascular death and myocardial infarction, resulted in imprecise estimates and insufficient data to evaluate this association. [10] Compared to healthy populations, vaccine performance may be decreased in populations with underlying respiratory and/or cardiovascular diseases, and meta-analyses indicate that there is insufficient evidence to conclude that vaccines are adequately effective in these groups.…”

Section: Disease Burdenmentioning

confidence: 99%

2012/13 influenza vaccine effectiveness against hospitalised influenza A(H1N1)pdm09, A(H3N2) and B: estimates from a European network of hospitals

Rondy¹,

Launay

Puig-Barberà

et al. 2015

Eurosurveillance

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Section: Disease Burdenmentioning

confidence: 99%

2012/13 influenza vaccine effectiveness against hospitalised influenza A(H1N1)pdm09, A(H3N2) and B: estimates from a European network of hospitals

Rondy¹,

Launay

Puig-Barberà

et al. 2015

Eurosurveillance

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“…Moreover, in mice, influenza propagates the inflammatory response, the progression and thrombosis of atherosclerotic plaques (Naghavi et al 2003). Influenza vaccination has been shown to be beneficial in reducing major cardiovascular events amongst acute coronary syndrome patients (Phrommintikul et al 2011). Furthermore, many other disparate acute and chronic pathogens, such as Clostridium pneumoniae (Vainas et al 2009), HIV (Ho and Hsue 2009), CMV (Simanek et al 2011) and gum disease-causing bacteria (Kebschull et al 2010), carry an elevated risk of CVD, suggesting that, rather than the nature of the infectious agent, it is the ensuing host-derived inflammatory response that drives this increased CVD risk.…”

Section: Seasonal Influenzamentioning

confidence: 99%

The role of the T cell in age-related inflammation

Macaulay

Akbar

Henson

2012

AGE

105

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Ageing is accompanied by alterations to T-cell immunity and also by a low-grade chronic inflammatory state termed inflammaging. The significance of these phenomena is highlighted by their being predictors of earlier mortality. We have recently published that the proinflammatory cytokine TNFα is a strong inducer of CD4 + T-cell senescence and T-cell differentiation, adding to the growing body of literature implicating proinflammatory molecules in mediating these critical age-related T-cell alterations. Moreover, the inflammatory process is also being increasingly implicated in the pathogenesis of many common and severe age-related diseases, including cancer, cardiovascular diseases and type 2 diabetes. Furthermore, major age-related risk factors for poor health, such as obesity, stress and smoking, are also associated with an upregulation in systemic inflammatory markers. We propose the idea that the ensuing inflammatory response to influenza infection propagates cardiovascular diseases and constitutes a major cause of influenzarelated mortality. While inflammation is not a negative phenomenon per se, this age-related dysregulation of inflammatory responses may play crucial roles driving age-related pathologies, T-cell immunosenescence and CMV reactivation, thereby underpinning key features of the ageing process.

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“…31,32 However, both of these RCTs enrolled a small number of patients, and thus may not have been sufficiently powered to detect a difference. Furthermore, small sample sizes may introduce confounding and bias, which may have resulted in overestimation of the true benefit for the RCTs with positive results.…”

Section: Discussionmentioning

confidence: 99%

“…[29][30][31][32][33][34] Two of the RCTs were assessed to be of moderate quality and one was of low quality according to the GRADE criteria; quality assessment could not be performed for the remaining 2 RCTs, which have not been formally published in full-text.…”

Section: Randomized Controlled Trialsmentioning

confidence: 99%

Influenza Vaccination for Secondary Prevention of Cardiovascular Events: A Systematic Review

LeBras

Barry

2017

CJHP

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RÉSUMÉContexte : La grippe est une infection courante des voies respiratoires qui peut causer des complications, notamment des événements cardiovasculaires. On a montré que la grippe double les risques d'infarctus du myocarde. De plus, les patients atteints d'une maladie cardiovasculaire sont les plus menacés. La vaccination contre la grippe a été associée à une réduction des cas d'infarctus du myocarde, de maladie cérébrovasculaire et de décès.Objectif : Évaluer les données probantes montrant que la vaccination contre la grippe permet de réduire le nombre d'événements cardiovasculaires chez les patients déjà atteints d'une maladie cardiovasculaire. Extraction et synthèse des données : Dix études répondaient aux critères de recherche (trois essais cliniques non aléatoires, cinq essais cliniques à répartition aléatoire et deux méta-analyses). Les essais cliniques non aléa-toires et les essais cliniques à répartition aléatoire présentaient des résultats variables en ce qui touche aux décès d'origine cardiovasculaire et aux événements cardiovasculaires indésirables. Les deux méta-analyses, qui avaient en commun quatre essais cliniques à répartition aléatoire concernant des patients atteints d'une maladie cardiovasculaire, montraient que le vaccin contre la grippe permettait de réduire le nombre de décès d'origine cardiovasculaire d'environ 50 % comparativement au groupe témoin. La vaccination a aussi réduit le nombre d'événements cardiovasculaires graves d'environ 43 %; le pourcentage était plus important (54 %) dans le sous-groupe de patients ayant récemment (à l'intérieur d'un an) souffert d'un syndrome coronarien aigu. Cependant, ces résultats sont potentiellement faussés par la petite taille des échantillons, les faibles taux d'événements et la variabilité avec laquelle on signale les résultats. Il y avait aussi une forte hétérogénéité clinique entre les études, ce qui pourrait ne pas être représentatif de la pratique actuelle. ABSTRACTBackground: Influenza is a common respiratory infection that may cause complications, including cardiovascular events. Influenza illness has been shown to double the risk of myocardial infarction, with the highest risk among patients with established cardiovascular disease. Vaccination against influenza has been associated with reductions in myocardial infarction, cerebrovascular disease, and death.

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Influenza vaccination reduces cardiovascular events in patients with acute coronary syndrome

Abstract: The influenza vaccine reduced major cardiovascular events in patients with ACS. Therefore, it should be encouraged as a secondary prevention in this group of patients.

Cited by 195 publications

References 25 publications

2012/13 influenza vaccine effectiveness against hospitalised influenza A(H1N1)pdm09, A(H3N2) and B: estimates from a European network of hospitals

2012/13 influenza vaccine effectiveness against hospitalised influenza A(H1N1)pdm09, A(H3N2) and B: estimates from a European network of hospitals

The role of the T cell in age-related inflammation

Influenza Vaccination for Secondary Prevention of Cardiovascular Events: A Systematic Review

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