Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand.
Eur Heart J. 2011 Jul;32(14):1730-5. doi: 10.1093/eurheartj/ehr004. Epub 2011 Feb 2.
Influenza infection has been shown to accentuate the progression of atherosclerosis and precipitate the occurrence of acute coronary syndrome (ACS). However, the protective effects of the influenza vaccine on cardiovascular events are still inconclusive.
The study was a prospective randomized open with blinded endpoint (PROBE) study. The 439 patients who had been admitted due to ACS within 8 weeks were enrolled and randomly allocated to receive inactivated influenza vaccine in the vaccine group and no treatment in the control group. All patients were treated with the standard therapy including revascularization according to primary cardiologists. The primary endpoint, which was the combined major cardiovascular events, including death, hospitalization from ACS, hospitalization from heart failure, and hospitalization from stroke, occurred less frequently in the vaccine group than the control group [9.5 vs. 19.3%, unadjusted HR 0.70 (0.57-0.86), P = 0.004]. There was no significant difference in the incidence of cardiovascular death between the vaccine and control groups [2.3 vs. 5.5%, unadjusted HR 0.39 (0.14-1.12), P = 0.088].
The influenza vaccine reduced major cardiovascular events in patients with ACS. Therefore, it should be encouraged as a secondary prevention in this group of patients.
已有研究表明，流感感染会加重动脉粥样硬化的进展，并促使急性冠状动脉综合征（ACS）的发生。然而，流感疫苗对心血管事件的保护作用仍存在争议。
这是一项前瞻性、随机、开放、设盲终点（PROBE）研究。共纳入 439 例在 8 周内因 ACS 住院的患者，按随机数字表法分为疫苗组（接种灭活流感疫苗）和对照组（不接种疫苗）。所有患者均接受标准治疗，包括根据主要心脏科医生的建议进行血运重建。疫苗组的主要终点（包括死亡、ACS 再住院、心力衰竭再住院和中风再住院的复合心血管主要不良事件）发生率低于对照组[9.5%比 19.3%，未校正 HR 0.70（0.57-0.86），P=0.004]。疫苗组和对照组心血管死亡的发生率无显著差异[2.3%比 5.5%，未校正 HR 0.39（0.14-1.12），P=0.088]。
流感疫苗可降低 ACS 患者的主要心血管不良事件风险。因此，在这组患者中应鼓励将其作为二级预防措施。
