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近期关于流感疫苗接种对心血管事件影响的一项经历。

A recent experience on the role of influenza vaccination on cardiovascular events.

作者信息

Sosa-Liprandi María Inés, Zaidel Ezequiel José, Sosa-Liprandi Álvaro

机构信息

Department of Cardiology, Sanatorio Güemes, Acuña de Figueroa 1228 C1180AAX, Buenos Aires, Argentina.

出版信息

Eur Heart J Suppl. 2023 Feb 14;25(Suppl A):A31-A35. doi: 10.1093/eurheartjsupp/suac111. eCollection 2023 Feb.

Abstract

The purpose of this review is to update the recent information regarding the role of influenza vaccination (IV) as a strategy to reduce cardiovascular (CV) events. During the last 2 years, new meta-analysis, guidelines, and two randomized controlled trials (RCTs) were published. The IAMI trial added information regarding the safety and efficacy of IV right after an acute myocardial infarction hospitalization. A significant reduction in the primary endpoint-including mortality-was observed. More recently, the influenza vaccine to prevent vascular events trial (IVVE) trial did not meet the primary CV endpoint in patients with heart failure (HF). However, a significant reduction was observed during the seasonal peaks of Influenza circulation. COVID-19 pandemic provoked recruitment difficulties in these trials, as well as an altered influenza seasonality and incidence. Further analysis of IVVE trial is needed to clarify the precise role of IV in patients with HF. A recent meta-analysis of RCTs and observational studies indicated that IV was safe and effective to reduce CV events, and it was included in the most updated guideline. Despite these benefits, and the recommendations for its prescription by scientific societies and health regulatory agencies, the vaccination rate remains below than expected globally. The correct understanding of implementation barriers, which involve doctors, patients, and their context, is essential when continuous improvement strategies are planned, in order to improve the IV rate in at-risk subjects.

摘要

本综述的目的是更新有关流感疫苗接种(IV)作为降低心血管(CV)事件策略的最新信息。在过去两年中,发表了新的荟萃分析、指南和两项随机对照试验(RCT)。IAMI试验补充了急性心肌梗死住院后立即进行IV接种的安全性和有效性信息。观察到主要终点(包括死亡率)显著降低。最近,预防血管事件流感疫苗试验(IVVE)在心力衰竭(HF)患者中未达到主要CV终点。然而,在流感流行的季节性高峰期间观察到显著降低。COVID-19大流行给这些试验带来了招募困难,以及流感季节性和发病率的改变。需要对IVVE试验进行进一步分析,以阐明IV在HF患者中的精确作用。最近一项对RCT和观察性研究的荟萃分析表明,IV接种对降低CV事件是安全有效的,并且它被纳入了最新指南。尽管有这些益处,以及科学协会和卫生监管机构对其处方的建议,但全球疫苗接种率仍低于预期。在规划持续改进策略时,正确理解涉及医生、患者及其背景的实施障碍,对于提高高危人群的IV接种率至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d3b2/10021488/04fcc1ab2b8c/suac111f1.jpg

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