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流感疫苗是预防主要不良心血管事件的最佳“手段”吗?当前证据、潜在机制及未来方向综述

Is Influenza Vaccination Our Best 'Shot' at Preventing MACE? Review of Current Evidence, Underlying Mechanisms, and Future Directions.

作者信息

El Khoury Alexia, Abou Farah Joy, Saade Elie

机构信息

Division of Infectious Diseases & HIV Medicine, University Hospitals Cleveland Medical Center, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA.

出版信息

Vaccines (Basel). 2025 May 14;13(5):522. doi: 10.3390/vaccines13050522.

Abstract

BACKGROUND

Major adverse cardiovascular events (MACE), including myocardial infarction, stroke, and cardiovascular death, are the leading contributors to global morbidity and mortality worldwide. Accumulating evidence suggests a strong association between influenza infection and increased risk of MACE, especially in high-risk populations. Influenza vaccination has been proposed as a potential strategy for reducing this risk by mitigating systemic inflammation and preventing atherosclerotic plaque destabilization, although the precise mechanisms remain under investigation.

RESULTS

Multiple meta-analyses and RCTs suggest that influenza vaccination is associated with a reduced risk of MACE, particularly in high-risk individuals with preexisting cardiovascular disease, but the results are less consistent for primary prevention in low-risk populations. The current data support the importance of early and annual vaccination for optimizing cardiovascular outcomes.

CONCLUSIONS

Influenza vaccination is emerging as an effective and accessible strategy to reduce the risk of major adverse cardiovascular events, particularly in high-risk individuals. While further research is needed to clarify its role in low-risk populations and the underlying mechanisms of protection, current evidence supports its integration into cardiovascular preventive care.

摘要

背景

主要不良心血管事件(MACE),包括心肌梗死、中风和心血管死亡,是全球发病和死亡的主要原因。越来越多的证据表明,流感感染与MACE风险增加之间存在密切关联,尤其是在高危人群中。尽管确切机制仍在研究中,但流感疫苗接种已被提议作为一种潜在策略,通过减轻全身炎症和预防动脉粥样硬化斑块不稳定来降低这种风险。

结果

多项荟萃分析和随机对照试验表明,流感疫苗接种与MACE风险降低相关,特别是在患有心血管疾病的高危个体中,但在低危人群的一级预防中结果不太一致。目前的数据支持早期和每年接种疫苗对优化心血管结局的重要性。

结论

流感疫苗接种正在成为一种有效且可及的策略,以降低主要不良心血管事件的风险,特别是在高危个体中。虽然需要进一步研究来阐明其在低危人群中的作用以及潜在的保护机制,但目前的证据支持将其纳入心血管预防保健。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e2e3/12115855/1b926b99624d/vaccines-13-00522-g001.jpg

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