School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Medicine, Division of Pulmonary, Critical Care, Sleep and Allergy, University of Miami, Coral Gables, Florida, USA.
Sci Rep. 2020 Nov 26;10(1):20656. doi: 10.1038/s41598-020-77679-7.
Cardiovascular diseases (CVDs) are among the leading causes of mortality and morbidity worldwide. There are many contrasting ideas on the effectiveness of influenza vaccination on CVDs. This study aimed to investigate the association between influenza vaccination and the risk of CVDs. We systematically searched all PubMed/Medline, EMBASE, and the Cochrane library entries up to November 2019 for studies of influenza vs. the CVDs outcomes. We conducted a random-effects meta-analysis using the inverse variance method for pooled risk ratios (RR) or odds ratios (OR) and evaluated statistical heterogeneity using the I statistic. We identified 17 studies (6 randomized controlled trial [RCT], 5 cohorts, and 6 case-control) with a total of 180,043 cases and 276,898 control participants. The pooled RR of developing CVDs after influenza vaccination in RCT studies was 0.55 (95% CI 0.41-0.73), which was significant (P-value = 0.00). The pooled OR of decreasing CVDs after influenza vaccination in cohort studies was 0.89 (95% CI 0.77-1.04). The pooled OR of developing CVDs after influenza vaccination by pooling case-control studies was 0.70 (95% CI 0.57-0.86, (P-value = 0.00). All of these studies suggest decreased risks of CVDs with influenza vaccination. The current study does support the protective role of influenza vaccination on CVDs events. Health authorities may develop evidence-based preventive strategies to offer influenza vaccination in patients with CVDs.
心血管疾病（CVDs）是全球范围内导致死亡和发病的主要原因之一。对于流感疫苗接种对 CVDs 的有效性，存在许多相互矛盾的观点。本研究旨在调查流感疫苗接种与 CVDs 风险之间的关联。我们系统地检索了所有 PubMed/Medline、EMBASE 和 Cochrane 图书馆的文献，截至 2019 年 11 月，以获取流感与 CVDs 结局相关的研究。我们使用逆方差法进行随机效应荟萃分析，以计算汇总风险比（RR）或优势比（OR），并使用 I 统计量评估统计异质性。我们确定了 17 项研究（6 项随机对照试验 [RCT]、5 项队列研究和 6 项病例对照研究），共纳入了 180043 例病例和 276898 例对照参与者。RCT 研究中流感疫苗接种后发生 CVDs 的汇总 RR 为 0.55（95% CI 0.41-0.73），具有统计学意义（P 值=0.00）。队列研究中流感疫苗接种后 CVDs 发生率降低的汇总 OR 为 0.89（95% CI 0.77-1.04）。通过合并病例对照研究，流感疫苗接种后发生 CVDs 的汇总 OR 为 0.70（95% CI 0.57-0.86，P 值=0.00）。所有这些研究都表明流感疫苗接种可降低 CVDs 的风险。本研究确实支持流感疫苗接种对 CVDs 事件的保护作用。卫生当局可能会制定基于证据的预防策略，为 CVDs 患者提供流感疫苗接种。
