The protective effect of pneumococcal vaccination on cardiovascular disease in adults: A systematic review and meta-analysis

International Journal of Infectious Diseases

卷:99

Angel Zhang¹  Fawziah Marra²  Nirma Khatri Vadlamudi²  Katherine Bessai³  Emma Gillman³  Kamalpreet Parhar³ 

[1] Corresponding author at: Faculty of Pharmaceutical Sciences, University of British Columbia, 2405 Wesbrook Mall, Vancouver, BC V6T 1Z3, Canada.;

[2] Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, Canada;

[3] Faculty of Sciences, The University of British Columbia, Vancouver, Canada;

关键词: Streptococcus pneumoniae;    PPV23;    Polysaccharide pneumococcal vaccine;    Cardiovascular disease;    Cerebrovascular disease;    Death;   

DOI  :  

来源: DOAJ

【 摘 要 】

Background: Epidemiological studies suggest that there is a link between pneumococcal infection and adverse cardiovascular outcomes such as myocardial infarction. Multiple studies have evaluated the protective effect of the 23-valent polysaccharide pneumococcal vaccination (PPV23), but results have varied. Therefore, a meta-analysis was conducted to summarize available evidence on the impact of PPV23 on cardiovascular disease. Methods: A literature search from January 1946 to September 2019 was conducted across Embase, Medline and Cochrane. All studies were included that evaluated PPV23 compared with a control (placebo, no vaccine or another vaccine) for any cardiovascular events, including: myocardial infarction (MI), heart failure and cerebrovascular events. Risk ratios (RRs) were pooled using random effects models. Results: Eighteen studies were included, with a total of 716,108 participants. Vaccination with PPV23 was associated with decreased risk of any cardiovascular event (RR: 0.91; 95% CI: 0.84−0.99), and MI (RR: 0.88; 95% CI: 0.79−0.98) in all age groups, with a significant effect in those aged ≥65 years, but not in the younger age group. Similarly, PPV23 vaccine was associated with significant risk reduction in all-cause mortality in all ages (RR: 0.78; 95% CI: 0.68−0.88), specifically in those aged ≥65 years (RR: 0.71; 95% CI: 0.60−0.84). A significant risk reduction in cerebrovascular disease was not observed following pneumococcal vaccination. Conclusions: Polysaccharide pneumococcal vaccination decreased the risk for some adverse cardiovascular events, specifically acute MI in the vaccinated population, particularly for those individuals aged ≥65 years. It would be highly beneficial to vaccinate the population who is at greater risk of cardiovascular diseases.

【 授权许可】

Unknown