Influenza vaccination in secondary prevention from coronary ischaemic events in coronary artery disease: FLUCAD study

• Published in: European heart journal Vol. 29; no. 11; pp. 1350 - 1358
• Main Authors: Ciszewski, Andrzej, Bilinska, Zofia T., Brydak, Lidia B., Kepka, Cezary, Kruk, Mariusz, Romanowska, Magdalena, Ksiezycka, Ewa, Przyluski, Jakub, Piotrowski, Walerian, Maczynska, Renata, Ruzyllo, Witold
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.06.2008; Oxford Publishing Limited (England)
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Cardiology. Vascular system; Coronary Artery Disease - mortality; Coronary disease; Coronary heart disease; Epidemiologic Methods; Female; Heart; Human viral diseases; Humans; Infection; Infectious diseases; Influenza; Influenza Vaccines - administration & dosage; Influenza, Human - epidemiology; Influenza, Human - prevention & control; Male; Medical sciences; Middle Aged; Myocardial Infarction - mortality; Myocardial Ischemia - mortality; Myocardial Ischemia - prevention & control; Prevention; Viral diseases; Viral diseases of the respiratory system and ent viral diseases; Infection; Prevention; Coronary disease; Influenza; Secondary; Vaccination; Cardiovascular disease; Influenza· Infection· Prevention; Coronary heart disease; Immunoprophylaxis; Ischemia; Viral disease; Circulatory system; Cardiology
• ISSN: 0195-668X; 1522-9645
• DOI: 10.1093/eurheartj/ehm581

Aims To evaluate the effect of influenza vaccination on the coronary events in patients with confirmed coronary artery disease (CAD). Methods and results Randomized, double-blind, placebo controlled study. We included 658 optimally treated CAD patients; 477 men, mean age 59.9±10.3 years. Three hundred and twenty-five patients received the influenza vaccine, and 333 patients placebo. Median follow-up was 298 (interquartile range 263–317) days. Primary endpoint was the cardiovascular death. Its estimated 12-month cumulative event rate was 0.63% in the vaccine vs. 0.76% in controls (HR 1.06 95% CI: 0.15–7.56, P = 0.95). There were two secondary composite endpoints: (i) the MACE (cardiovascular death, myocardial infarction, coronary revascularization) tended to occur less frequently in the vaccine group vs. placebo with the event rate 3.00 and 5.87%, respectively (HR 0.54;95% CI: 0.24–1.21, P = 0.13). (ii) Coronary ischaemic event (MACE or hospitalization for myocardial ischaemia) estimated 12-month event rate was significantly lower in the vaccine group 6.02 vs. 9.97% in controls (HR 0.54; 95% CI: 0.29–0.99, P = 0.047). Conclusion In optimally treated CAD patients influenza vaccination improves the clinical course of CAD and reduces the frequency of coronary ischaemic events. Large-scale studies are warranted to evaluate the effect of influenza vaccination on cardiovascular mortality. (ClinicalTrials.gov: NCT 00371098).