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流感疫苗接种对心力衰竭患者再次住院的影响。

Influence of influenza vaccination on recurrent hospitalization in patients with heart failure.

作者信息

Kaya H, Beton O, Acar G, Temizhan A, Cavusoğlu Y, Guray U, Zoghi M, Ural D, Ekmekci A, Gungor H, Sari I, Oguz D, Yucel H, Zorlu A, Yilmaz M B

机构信息

Faculty of Medicine, Department of Cardiology, Cumhuriyet University, 58140, Sivas, Turkey.

Faculty of Medicine, Department of Cardiology, Sutcu Imam University, Kahramanmaras, Turkey.

出版信息

Herz. 2017 May;42(3):307-315. doi: 10.1007/s00059-016-4460-2. Epub 2016 Jul 26.

Abstract

BACKGROUND

The current study aimed to evaluate the influence of regular annual influenza vaccinations on cardiovascular (CV) death and heart failure-related hospitalizations (HFrH) in stable outpatients with heart failure with reduced ejection fraction.

METHODS

The Turkish research team-HF (TREAT-HF) is a network undertaking multicenter, observational cohort studies in HF. This study is a subgroup analysis of TREAT-HF outpatient cohorts who completed a questionnaire on influenza vaccination status and for whom follow-up data were available. A total of 656 patients with available follow-up data for CV death and HFrH including recurrent hospitalization were included in the study. Patients were classified into two groups: those who received regular influenza vaccination (40 %) and those who did not receive vaccination.

RESULTS

During a mean follow-up of 15 ±6 months, 113 (18 %) patients had CV death and 471 (72 %) patients had at least one HFrH. The CV death rate was similar in both groups of patients (16 vs. 19 %, p = 0.37), whereas, HFrH and recurrent HFrH were significantly less frequently encountered in patients who received regular influenza vaccination than in those who did not receive vaccination (43 vs. 92 % and 16 vs. 66 %, p < 0.001, respectively). In a multivariate Cox proportional hazards model - in addition to a few clinical factors - vaccination status (HR = 0.30, 95 % CI = 0.17-0.51, p < 0.001) and graduation from university (HR = 0.35, 95 % CI = 0.17-0.72, p = 0.004) remained independently associated with the risk of recurrent HFrH.

CONCLUSION

Regular influenza vaccination does not influence CV deaths; however, it decreases HFrH including recurrent episodes of HFrH in outpatients with heart failure with reduced ejection fraction.

摘要

背景

本研究旨在评估定期年度流感疫苗接种对射血分数降低的稳定型心力衰竭门诊患者心血管(CV)死亡和心力衰竭相关住院(HFrH)的影响。

方法

土耳其研究团队-心力衰竭(TREAT-HF)是一个开展心力衰竭多中心观察性队列研究的网络。本研究是对TREAT-HF门诊队列的亚组分析,这些队列完成了关于流感疫苗接种状况的问卷调查且有随访数据。共有656例有CV死亡和HFrH(包括再住院)随访数据的患者纳入研究。患者分为两组:接受定期流感疫苗接种的患者(40%)和未接种疫苗的患者。

结果

在平均15±6个月的随访期间,113例(18%)患者发生CV死亡,471例(72%)患者至少有一次HFrH。两组患者的CV死亡率相似(16%对19%,p = 0.37),然而,接受定期流感疫苗接种的患者发生HFrH和再发HFrH的频率显著低于未接种疫苗的患者(分别为43%对92%和16%对66%,p均<0.001)。在多变量Cox比例风险模型中,除了一些临床因素外,疫苗接种状况(HR = 0.30,95%CI = 0.17 - 0.51,p < 0.001)和大学毕业(HR = 0.35,95%CI = 0.17 - 0.72,p = 0.004)仍与再发HFrH风险独立相关。

结论

定期流感疫苗接种不影响CV死亡;然而,它可降低射血分数降低的心力衰竭门诊患者的HFrH,包括HFrH的再发情况。

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