tetano
Editor, Senior Moderator
Expert Rev Vaccines. 2019 Nov 6. doi: 10.1080/14760584.2019.1690459. [Epub ahead of print] [h=1]The association of Influenza infection and vaccine with myocardial infarction: systematic review and meta-analysis of self-controlled case series.[/h]
Caldeira D[SUP]1,[/SUP][SUP]2,[/SUP][SUP]3[/SUP], Rodrigues B[SUP]2[/SUP], David C[SUP]1,[/SUP][SUP]2,[/SUP][SUP]3[/SUP], Costa J[SUP]2,[/SUP][SUP]3[/SUP], Pinto FJ[SUP]1[/SUP], Ferreira JJ[SUP]2,[/SUP][SUP]3[/SUP].
[h=3]Author information[/h] 1 Servi?o de Cardiologia, Hospital Universit?rio de Santa Maria (CHLN), CAML, Centro Cardiovascular da Universidade de Lisboa - CCUL, Faculdade de Medicina, Universidade de Lisboa. Avenida Professor Egas Moniz, 1649-028, Lisboa, Portugal. 2 Laborat?rio de Farmacologia Cl?nica e Terap?utica, Faculdade de Medicina, Universidade de Lisboa. Avenida Professor Egas Moniz, 1649-028, Lisboa, Portugal. 3 Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa. Avenida Professor Egas Moniz, 1649-028, Lisboa, Portugal.
[h=3]Abstract[/h] Introduction: Influenza vaccination may be beneficial in coronary disease patients; however the infection and vaccination are associated to acute inflammation, a trigger of cardiovascular events. We aimed to review the risk of myocardial infarction (MI) associated with Influenza infection and the safety of vaccination in self-controlled case series (SCCS).Methods: We performed a systematic review with meta-analysis of SCCS studies to evaluate the risk of MI associated with Influenza infection or vaccination. Database search was performed in August 2018. The data were reported using the incident rate ratio (IRR) and 95% confidence interval (95%CI).Results: 3 studies for Influenza infection and 2 studies for Influenza vaccination were eligible. The risk of MI following an Influenza infection (3 studies) was significantly increased in the first 3 days (IRR 5.79; 95%CI: 3.59-9.38) and between 4-7 days (IRR 4.52; 95%CI: 2.80-7.32). In the first 4 weeks following the vaccination against Influenza there was a significant decrease of MI risk (IRR 0.84, 95%CI: 0.78-0.91).Conclusions: Short-term MI risk in Influenza infection is significantly increased, with a low-to-moderate confidence in the pooled evidence. The Influenza vaccine was safe regarding short-term risk for MI, and the significant risk reduction is possibly related to a healthy period bias.
[h=4]KEYWORDS:[/h] Coronary artery disease; Influenza; Pneumonia; Respiratory infection; Vaccine; inflammation; ischemia; ischemic heart disease
PMID: 31693865 DOI: 10.1080/14760584.2019.1690459
Caldeira D[SUP]1,[/SUP][SUP]2,[/SUP][SUP]3[/SUP], Rodrigues B[SUP]2[/SUP], David C[SUP]1,[/SUP][SUP]2,[/SUP][SUP]3[/SUP], Costa J[SUP]2,[/SUP][SUP]3[/SUP], Pinto FJ[SUP]1[/SUP], Ferreira JJ[SUP]2,[/SUP][SUP]3[/SUP].
[h=3]Author information[/h] 1 Servi?o de Cardiologia, Hospital Universit?rio de Santa Maria (CHLN), CAML, Centro Cardiovascular da Universidade de Lisboa - CCUL, Faculdade de Medicina, Universidade de Lisboa. Avenida Professor Egas Moniz, 1649-028, Lisboa, Portugal. 2 Laborat?rio de Farmacologia Cl?nica e Terap?utica, Faculdade de Medicina, Universidade de Lisboa. Avenida Professor Egas Moniz, 1649-028, Lisboa, Portugal. 3 Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa. Avenida Professor Egas Moniz, 1649-028, Lisboa, Portugal.
[h=3]Abstract[/h] Introduction: Influenza vaccination may be beneficial in coronary disease patients; however the infection and vaccination are associated to acute inflammation, a trigger of cardiovascular events. We aimed to review the risk of myocardial infarction (MI) associated with Influenza infection and the safety of vaccination in self-controlled case series (SCCS).Methods: We performed a systematic review with meta-analysis of SCCS studies to evaluate the risk of MI associated with Influenza infection or vaccination. Database search was performed in August 2018. The data were reported using the incident rate ratio (IRR) and 95% confidence interval (95%CI).Results: 3 studies for Influenza infection and 2 studies for Influenza vaccination were eligible. The risk of MI following an Influenza infection (3 studies) was significantly increased in the first 3 days (IRR 5.79; 95%CI: 3.59-9.38) and between 4-7 days (IRR 4.52; 95%CI: 2.80-7.32). In the first 4 weeks following the vaccination against Influenza there was a significant decrease of MI risk (IRR 0.84, 95%CI: 0.78-0.91).Conclusions: Short-term MI risk in Influenza infection is significantly increased, with a low-to-moderate confidence in the pooled evidence. The Influenza vaccine was safe regarding short-term risk for MI, and the significant risk reduction is possibly related to a healthy period bias.
[h=4]KEYWORDS:[/h] Coronary artery disease; Influenza; Pneumonia; Respiratory infection; Vaccine; inflammation; ischemia; ischemic heart disease
PMID: 31693865 DOI: 10.1080/14760584.2019.1690459