Effects of Influenza Vaccine on Mortality and Cardiovascular Outcomes in Patients With Cardiovascular Disease: A Systematic Review and Meta‐Analysis

Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease

Heather Johnson¹  Muhammad Zia Khan²  Ahmed N. Lone²  Siva H. Yedlapati²  Swapna Talluri³  Muhammad Shahzeb Khan⁴  Safi U. Khan⁵  Ann M. Navar⁶  Martha Gulati⁷  Seth Baum⁸  Erin D. Michos⁹ 

[1] Boca Raton Regional Hospital/Baptist Health of South Florida Boca Raton FL;Department of Medicine Erie County Medical Center Buffalo NY;Department of Medicine Guthrie Health System/Robert Packer Hospital Sayre PA;Department of Medicine John H Stroger Jr. Hospital of Cook County Chicago IL;Department of Medicine West Virginia University Morgantown WV;Division of Cardiology UT Southwestern Medical Center Dallas TX;Division of Cardiology University of Arizona Phoenix AZ;Excel Medical Clinical Trials Boca Raton FL;The Ciccarone Center for the Prevention of Cardiovascular Disease Johns Hopkins School of Medicine Baltimore MD;

关键词: cardiovascular disease;    influenza vaccine;    meta‐analysis;    mortality;   

DOI  :  10.1161/JAHA.120.019636

来源: DOAJ

【 摘 要 】

Background Influenza infection causes considerable morbidity and mortality in patients with cardiovascular disease. We assessed the effects of the influenza vaccine on mortality and cardiovascular outcomes in patients with cardiovascular disease. Methods and Results We searched PubMed, Embase, and the Cochrane Library through January 2020 for randomized controlled trials and observational studies assessing the effects of influenza vaccine on mortality and cardiovascular outcomes in patients with cardiovascular disease. Estimates were reported as random effects risk ratios (RRs) with 95% CIs. Analyses were stratified by study design into randomized controlled trials and observational studies. A total of 16 studies (n=237 058), including 4 randomized controlled trials (n=1667) and 12 observational studies (n=235 391), were identified. Participants' mean age was 69.2±7.01 years, 36.6% were women, 65.1% had hypertension, 31.1% had diabetes mellitus, and 23.4% were smokers. At a median follow‐up duration of 19.5 months, influenza vaccine was associated with a lower risk of all‐cause mortality (RR, 0.75; 95% CI, 0.60–0.93 [P=0.01]), cardiovascular mortality (RR, 0.82; 95% CI, 0.80–0.84 [P<0.001]), and major adverse cardiovascular events (RR, 0.87; 95% CI, 0.80–0.94 [P<0.001]) compared with control. The use of the influenza vaccine was not associated with a statistically significant reduction of myocardial infarction (RR, 0.73; 95% CI, 0.49–1.09 [P=0.12]) compared with control. Conclusions Data from both randomized controlled trials and observational studies support the use of the influenza vaccine in adults with cardiovascular disease to reduce mortality and cardiovascular events, as currently supported by clinical guidelines. Clinicians and health systems should continue to promote the influenza vaccine as part of comprehensive secondary prevention.

【 授权许可】

Unknown