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Primary prevention of acute cardiovascular events by influenza vaccination: an observational study

Davidson, Jennifer A; Banerjee, Amitava; Douglas, Ian; Leyrat, Clémence; Pebody, Richard; McDonald, Helen I; Herrett, Emily; ... Warren-Gash, Charlotte; + view all (2022) Primary prevention of acute cardiovascular events by influenza vaccination: an observational study. European Heart Journal 10.1093/eurheartj/ehac737. (In press). Green open access

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Abstract

AIMS: Previous studies show a reduced incidence of first myocardial infarction and stroke 1–3 months after influenza vaccination, but it is unclear how underlying cardiovascular risk impacts the association. METHODS AND RESULTS: The study used linked Clinical Practice Research Datalink, Hospital Episode Statistics Admitted Patient Care and Office for National Statistics mortality data from England between 1 September 2008 and 31 August 2019. From the data, individuals aged 40–84 years with a first acute cardiovascular event and influenza vaccination occurring within 12 months of each September were selected. Using a self-controlled case series analysis, season-adjusted cardiovascular risk stratified incidence ratios (IRs) for cardiovascular events after vaccination compared with baseline time before and >120 days after vaccination were generated. 193 900 individuals with a first acute cardiovascular event and influenza vaccine were included. 105 539 had hypertension and 172 050 had a QRISK2 score ≥10%. In main analysis, acute cardiovascular event risk was reduced in the 15–28 days after vaccination [IR 0.72 (95% CI 0.70–0.74)] and, while the effect size tapered, remained reduced to 91–120 days after vaccination [0.83 (0.81–0.88)]. Reduced cardiovascular events were seen after vaccination among individuals of all age groups and with raised and low cardiovascular risk. CONCLUSIONS: Influenza vaccine may offer cardiovascular benefit among individuals at varying cardiovascular risk. Further studies are needed to characterize the populations who could derive the most cardiovascular benefits from vaccination.

Type: Article
Title: Primary prevention of acute cardiovascular events by influenza vaccination: an observational study
Open access status: An open access version is available from UCL Discovery
DOI: 10.1093/eurheartj/ehac737
Publisher version: https://doi.org/10.1093/eurheartj/ehac737
Language: English
Additional information: © The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/).
Keywords: Influenza vaccine, Cardiovascular complications, hypertension, QRISK
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Health Informatics
URI: https://discovery-pp.ucl.ac.uk/id/eprint/10162189
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