Division of Infection Control and Biosafety, Centers for Disease Control, Taipei, Taiwan.
Division of Infectious Diseases, Department of Internal Medicine, National Yang-Ming University Hospital, Yilan County, Taiwan.
PLoS One. 2019 Jul 1;14(7):e0219172. doi: 10.1371/journal.pone.0219172. eCollection 2019.
The present study aimed to evaluate the association between influenza vaccination and the secondary prevention of cardiovascular disease (CVD) among elderly persons. This retrospective cohort study used the Geriatric Dataset of Taiwan's National Health Insurance Research Database (2000-2013). Patients aged ≥ 65 years who had been hospitalized for the first episodes of myocardial infarction were eligible. The vaccinated cohort comprised patients who received one dose of influenza vaccine within 180 days after discharge. The unvaccinated cohort included those who did not receive influenza vaccination and was propensity score-matched (1:1) for known CVD risk factors. All-cause death, acute myocardial infarction or cardiovascular death, and hospitalization for heart failure were assessed 1 year after the 181st day after hospital discharge. Compared with the matched cohort (n = 4,350), the vaccinated cohort (n = 4,350) had significantly lower incidences of all-cause death (hazard ratios [HR] 0.82, 95% CI [confidence interval] 0.73-0.92), myocardial infarction or cardiovascular death (HR 0.84, 95% CI 0.74-0.96), and hospitalization for heart failure (HR 0.83, 95% CI 0.74-0.92). The association between influenza vaccination and reduction of CVDs was similar across different subgroups. Cumulative incidence curves of the CVDs of interest for the two cohorts separated within the initial 3 months of follow-up (P < 0.05). Influenza vaccination was associated with a reduced risk of CVD in the elderly population with previous myocardial infarction.
本研究旨在评估流感疫苗接种与老年人心血管疾病（CVD）二级预防之间的关联。这项回顾性队列研究使用了台湾全民健康保险研究数据库的老年数据集（2000-2013 年）。符合条件的患者为因首次心肌梗死住院的年龄≥65 岁的患者。接种组包括出院后 180 天内接受一剂流感疫苗的患者。未接种组包括未接种流感疫苗且根据已知 CVD 危险因素进行倾向评分匹配（1:1）的患者。所有原因死亡、急性心肌梗死或心血管死亡以及心力衰竭住院的情况在出院后第 181 天进行评估。与匹配队列（n=4350）相比，接种组（n=4350）的全因死亡率（风险比 [HR] 0.82，95%置信区间 [CI] 0.73-0.92）、心肌梗死或心血管死亡（HR 0.84，95%CI 0.74-0.96）和心力衰竭住院率（HR 0.83，95%CI 0.74-0.92）均显著降低。流感疫苗接种与 CVD 减少之间的关联在不同亚组中相似。在随访的最初 3 个月内，两个队列的 CVD 累积发生率曲线分离（P<0.05）。流感疫苗接种与既往心肌梗死老年人群 CVD 风险降低相关。
