Abstract
Background
Influenza can cause a significant burden on patients with coronary artery disease.
This meta-analysis assessed the effectiveness of influenza vaccination in patients
with acute coronary syndrome and stable coronary artery disease.
Methods
We searched the Cochrane Controlled Register of Trials (CENTRAL), Embase, MEDLINE,
www.ClinicalTrials.gov, and the World Health Organization International Clinical Trials Registry Platform
from inception to September 2021. Estimates were summarized using the Mantel-Haenzel
method and a random-effects model. To assess heterogeneity the I² statistic was used.
Results
Five randomized trials, comprising 4187 patients, were included, 2 of which included
patients with acute coronary syndrome and 3 that included patients with stable coronary
artery disease and acute coronary syndrome. Influenza vaccination significantly reduced
the risk for all-cause mortality (relative risk [RR] = 0.56; 95% confidence interval
[CI], 0.38-0.84), cardiovascular mortality (RR = 0.54; 95% CI, 0.37-0.80), major acute
cardiovascular events (RR = 0.66; 95% CI, 0.49-0.88), and acute coronary syndrome
(RR = 0.63; 95% CI, 0.44-0.89). On subgroup analysis, influenza vaccination remained
effective for these outcomes in acute coronary syndrome but did not meet statistical
significance in coronary artery disease. Furthermore, influenza vaccination did not
reduce the risk for revascularization (RR = 0.89; 95% CI, 0.54-1.45), stroke or transient
ischemic attack (RR = 0.85; 95% CI, 0.31-2.32), or heart failure hospitalization (RR = 0.91;
95% CI, 0.21-4.00).
Conclusions
Influenza vaccine is a cheap and effective intervention to reduce the risk for all-cause
mortality, cardiovascular mortality, major acute cardiovascular events, and acute
coronary syndrome among coronary artery disease patients, especially in those with
acute coronary syndrome.
Keywords
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Article info
Publication history
Published online: February 19, 2023
Accepted:
February 2,
2023
Received:
November 2,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
Funding: None.
Conflicts of Interest: None.
Authorship: All authors had access to the data and a role in writing the manuscript.
Identification
Copyright
© 2023 Published by Elsevier Inc.
