tetano
Editor, Senior Moderator
Travel Med Infect Dis
. 2024 Dec 20:102793.
doi: 10.1016/j.tmaid.2024.102793. Online ahead of print. Association between influenza vaccination and prognosis in patients with ischemic heart disease: a systematic review and meta-analysis
Xiao Liu[SUP] 1 [/SUP], Jiayu Zhang[SUP] 2 [/SUP], Fuwei Liu[SUP] 3 [/SUP], Yifan Wu[SUP] 2 [/SUP], Lin Li[SUP] 4 [/SUP], Ruoyun Fan[SUP] 2 [/SUP], Changchang Fang[SUP] 2 [/SUP], Jinyi Huang[SUP] 2 [/SUP], Deju Zhang[SUP] 5 [/SUP], Peng Yu[SUP] 2 [/SUP], Huilei Zhao[SUP] 6 [/SUP]
Affiliations
Background: There is substantial epidemiological evidence demonstrating that influenza contributes to cardiovascular events in patients who already have cardiovascular diseases. However, it is unclear the extent to which influenza vaccination influences the prognosis of patients with ischemic heart disease (IHD).
Methods: We conducted a search for eligible randomized controlled trials (RCTs) in PubMed, Cochrane, and Embase on March 11, 2024, to investigate the effect of the influenza vaccine on the prognosis of patients with IHD. The effect sizes were combined using random-effects models, and the Trial Sequential Analysis (TSA) was used to assess the reliability and validity of the results.
Results: Five RCTs with a total of 5,659 patients with IHD were included. Use of influenza vaccine reduced the risk of major cardiovascular events (risk ratio [RR]=0.67, 95% confidence interval [CI] 0.52-0.87, number-needed-to-treat [NNT] of 37, high certainty), cardiovascular death (RR=0.55, 95%CI 0.35-0.87, moderate certainty), all-cause mortality (RR=0.58, 95%CI 0.40-0.84, high certainty) and myocardial infarction (MI) (RR=0.66, 95%CI 0.46-0.93, high certainty) in patients with IHD compared with control. The analysis revealed no significant benefit regarding hospitalization for heart failure (HF) (RR=0.91, 95%CI 0.21-3.99, moderate certainty) and revascularization (RR=0.59, 95%CI 0.10-3.45, moderate certainty). The NNT to avoid 1 event was 37 for major adverse cardiovascular events (MACE), 56 for cardiovascular death, 67 for MI, 41 for all-cause death. TSA showed that the benefit of influenza vaccine in reducing MACE was conclusive.
Conclusion: These studies suggested that the use of influenza vaccine may reduce the risk of MACE in patients with IHD.
Keywords: Meta-analysis; disease outcome; influenza vaccine; ischemic heart disease.
. 2024 Dec 20:102793.
doi: 10.1016/j.tmaid.2024.102793. Online ahead of print. Association between influenza vaccination and prognosis in patients with ischemic heart disease: a systematic review and meta-analysis
Xiao Liu[SUP] 1 [/SUP], Jiayu Zhang[SUP] 2 [/SUP], Fuwei Liu[SUP] 3 [/SUP], Yifan Wu[SUP] 2 [/SUP], Lin Li[SUP] 4 [/SUP], Ruoyun Fan[SUP] 2 [/SUP], Changchang Fang[SUP] 2 [/SUP], Jinyi Huang[SUP] 2 [/SUP], Deju Zhang[SUP] 5 [/SUP], Peng Yu[SUP] 2 [/SUP], Huilei Zhao[SUP] 6 [/SUP]
Affiliations
- PMID: 39710016
- DOI: 10.1016/j.tmaid.2024.102793
Background: There is substantial epidemiological evidence demonstrating that influenza contributes to cardiovascular events in patients who already have cardiovascular diseases. However, it is unclear the extent to which influenza vaccination influences the prognosis of patients with ischemic heart disease (IHD).
Methods: We conducted a search for eligible randomized controlled trials (RCTs) in PubMed, Cochrane, and Embase on March 11, 2024, to investigate the effect of the influenza vaccine on the prognosis of patients with IHD. The effect sizes were combined using random-effects models, and the Trial Sequential Analysis (TSA) was used to assess the reliability and validity of the results.
Results: Five RCTs with a total of 5,659 patients with IHD were included. Use of influenza vaccine reduced the risk of major cardiovascular events (risk ratio [RR]=0.67, 95% confidence interval [CI] 0.52-0.87, number-needed-to-treat [NNT] of 37, high certainty), cardiovascular death (RR=0.55, 95%CI 0.35-0.87, moderate certainty), all-cause mortality (RR=0.58, 95%CI 0.40-0.84, high certainty) and myocardial infarction (MI) (RR=0.66, 95%CI 0.46-0.93, high certainty) in patients with IHD compared with control. The analysis revealed no significant benefit regarding hospitalization for heart failure (HF) (RR=0.91, 95%CI 0.21-3.99, moderate certainty) and revascularization (RR=0.59, 95%CI 0.10-3.45, moderate certainty). The NNT to avoid 1 event was 37 for major adverse cardiovascular events (MACE), 56 for cardiovascular death, 67 for MI, 41 for all-cause death. TSA showed that the benefit of influenza vaccine in reducing MACE was conclusive.
Conclusion: These studies suggested that the use of influenza vaccine may reduce the risk of MACE in patients with IHD.
Keywords: Meta-analysis; disease outcome; influenza vaccine; ischemic heart disease.