The following are key points to remember about the influenza vaccine as a coronary intervention for prevention of acute myocardial infarction (AMI):

1. Influenza is one of the leading infectious causes of morbidity and mortality globally, and evidence is accumulating that it can precipitate AMI.
2. The pathobiology is thought to be due to a range of factors including enhanced sympathetic activity, hypoxemia, inflammatory release of cytokines, coronary plaque disruption, and thrombogenesis, which may result in thrombotic occlusion of the coronary artery.
3. Estimates of the efficacy of influenza vaccine in preventing AMI range from 15% to 45%, which is in a similar range of efficacy compared with proven routine coronary prevention measures such as smoking cessation (32–43%), statins (19–30%), and antihypertensive therapy (17–25%).
4. Universal use of the seasonal flu vaccine is considered standard practice in the United States, but not throughout the world. Considering the weight of evidence, rather than a randomized trial, seasonal influenza vaccine should be considered as an integral part of cardiovascular disease (CVD) management and prevention.
5. While it is recommended in many guidelines, rates of vaccination in risk groups aged <65 years are in the range of 30%. The incorporation of vaccination into routine CVD prevention in patient care requires a clinical practice paradigm change.

Keywords: Acute Coronary Syndrome, Antihypertensive Agents, Cardiovascular Diseases, Cytokines, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Influenza Vaccines, Influenza, Human, Myocardial Infarction, Patient Care, Plaque, Atherosclerotic, Primary Prevention, Risk, Smoking Cessation, Thrombosis, Vaccination

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