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Evidence summaries

Influenza Vaccines for Preventing Cardiovascular Disease

In patients with cardiovascular disease, influenza vaccination may reduce cardiovascular mortality and combined cardiovascular events. There is insufficient evidence whether influenza vaccination has a role to play in the primary prevention of cardiovascular disease. Level of evidence: "C"

A Cochrane review [Abstract] 1 included 8 studies with a total of 12 029 subjects. Four trials (n = 10 347) focused on prevention of influenza in the general or elderly population and reported cardiovascular outcomes among their safety analyses; four trials (n = 1 682) focused on prevention of cardiovascular events in patients with established coronary heart disease. Follow-up continued between 42 days and one year. Cardiovascular mortality was reported by four secondary prevention trials and was significantly reduced by influenza vaccination overall (RR 0.45, 95% CI 0.26 to 0.76), and by three trials reporting cardiovascular mortality as part of their safety analyses when the numbers of events were too small to permit conclusions. In studies of patients with coronary heart disease, composite outcomes of cardiovascular events tended to be decreased with influenza vaccination compared with placebo.

Comment: The quality of evidence is downgraded by study quality (unclear allocation concealment) and inconsistency.

    References

    • Clar C, Oseni Z, Flowers N et al. Influenza vaccines for preventing cardiovascular disease. Cochrane Database Syst Rev 2015;5():CD005050. [PubMed]

Primary/Secondary Keywords