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Flu vaccine lowers risk for death in patients with HF
ORLANDO, Fla. — Patients with HF who received an influenza vaccination cut their risk for death during influenza season in half and risk for mortality the rest of the year by 20%.
To further explore the link between influenza vaccination on mortality and hospitalization in patients with HF, Hidekatsu Fukuta, MD, cardiologist at Nagoya City University Graduate School of Medical Sciences in Nagoya, Japan, and colleagues conducted a meta-analysis of six studies performed in the United States, Europe and Asia. In total, data for more than 78,000 patients with HF were analyzed. Five studies were observational and one was a retrospective analysis.
“Although there are no published randomized controlled trials examining the effect of influenza vaccination on clinical outcomes in heart failure patients, the effect has been examined in observational cohort studies. Nevertheless, results are inconsistent due partly to limited power with small sample sizes,” Fukuta told Cardiology Today. “To our knowledge, the present study is the first meta-analysis of the effect of influenza vaccination on mortality in heart failure patients.”
Influenza vaccination was linked to reduced risk for mortality during influenza (RR = 0.52; 95% CI, 0.39-0.69) and non-influenza (RR = 0.79; 95% CI, 0.69-0.9) seasons, according to a pooled analysis of confounder-adjusted HRs.
The researchers also found that patients with HF who received an influenza vaccination had reduced risk for CV rehospitalization (RR = 0.78; 95% CI, 0.68-0.89) during influenza season, but the same trend was not observed for all-cause hospitalization.
Across the six studies, the proportion of patients with HF who received an influenza vaccine ranged from 26% to 86%, showing wide variability in vaccination rates in this population. According to the researchers, this variability may be related to limited guideline recommendations for influenza vaccination in patients with HF. The Heart Failure Society of America recommends annual influenza vaccination in all patients with HF and no known contraindications, while the ACC/American Heart Association and European Society of Cardiology guidelines contain no specific recommendations for influenza vaccination in patients with HF. The CDC recommends that every person aged 6 months and older should receive an influenza vaccination each year and also encourages patients with CVD to remain on an immunization schedule and have a discussion with their physician, according to information in a press release.
Looking ahead, Fukuta said “large-scale and adequately powered [randomized controlled trials] should be planned to confirm our observed potential survival benefit of influenza vaccination in these patients.” – by Dave Quaile
Reference:
Fukuta H. Abstract 1238-089. Presented at: American College of Cardiology Scientific Session; March 10-12, 2018; Orlando, Fla.
Disclosure: Fukuta reports no relevant financial disclosures.