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

• Published in: Herz Vol. 42; no. 3; pp. 307 - 315
• Main Authors: 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.
• Format: Journal Article
• Language: English
• Published: Munich Springer Medizin 01.05.2017; Springer Nature B.V
• Subjects: Cardiology; Comorbidity; Death; Death, Sudden, Cardiac - epidemiology; Death, Sudden, Cardiac - prevention & control; Female; Follow-Up Studies; Hazards; Heart; Heart diseases; Heart failure; Heart Failure - mortality; Heart Failure - prevention & control; Humans; Immunization; Influenza; Influenza Vaccines - therapeutic use; Influenza, Human - mortality; Influenza, Human - prevention & control; Internal Medicine; Male; Medicine; Medicine & Public Health; Middle Aged; Mortality; Original Articles; Patient Readmission - statistics & numerical data; Patients; Prevalence; Risk Factors; Turkey - epidemiology; Vaccination; Vaccination - utilization; Vaccines; Heart failure; Outpatients; Hospitalisierung; Impfung; Influenza; Vaccination; Hospitalization; Herzinsuffizienz; Ambulante Patienten
• ISSN: 0340-9937; 1615-6692
• DOI: 10.1007/s00059-016-4460-2

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.