Flu Vaccine Associated With Lower Risk of Cardiovascular Events

Receiving an influenza vaccination was associated with a lower risk of major adverse cardiovascular events such as heart failure or hospitalization for heart attack, with the greatest treatment effect seen among patients with recent acute coronary syndrome (ACS; such as heart attack or unstable angina), according to a meta-analysis published in the October 23/30 issue of JAMA.

“Among nontraditional cardiovascular risk factors, there remains interest in a potential association between respiratory tract infections, of which influenza and influenza-like illnesses are common causes, and subsequent cardiovascular events,” according to background information in the article. Several epidemiological studies have suggested a strong inverse relationship between influenza vaccination and the risk of fatal and nonfatal cardiovascular events.

Jacob A. Udell, M.D., M.P.H., F.R.C.P.C., of the University of Toronto, and colleagues conducted a meta-analysis of all randomized clinical trials (RCTs) of influenza vaccine that studied cardiovascular events as efficacy or safety outcomes to determine if influenza vaccination is associated with prevention of cardiovascular events. The researchers identified five published and 1 unpublished RCTs of 6,735 patients (average age, 67 years; 51 percent women; 36 percent with a cardiac history; average follow-up time, 7.9 months) that met inclusion criteria for the study. Analyses were stratified by subgroups of patients with and without a history of acute coronary syndrome (ACS) within 1 year of randomization.

In the 5 published RCTs, 95 of 3,238 patients treated with influenza vaccine (2.9 percent) developed a major adverse cardiovascular event compared with 151 of 3,231 patients (4.7 percent) treated with placebo or control within 1 year of follow-up, an absolute risk difference favoring flu vaccine of 1.74 percent. The addition of the unpublished data did not materially change the results (2.9 percent influenza vaccine vs. 4.6 percent placebo or control).