Influenza Vaccine for Prevention of Myocardial Infarction
- MacIntyre CR, Mahimbo A, Moa AM, Barnes M.
- Influenza Vaccine as a Coronary Intervention for Prevention of Myocardial Infarction. Heart 2016;Sep 19:[Epub ahead of print].
The following are key points to remember about the influenza vaccine as a coronary intervention for prevention of acute myocardial infarction (AMI):
- Influenza is one of the leading infectious causes of morbidity and mortality globally, and evidence is accumulating that it can precipitate AMI.
- 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.
- 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%).
- 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.
- 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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