Article: Effectiveness of the influenza vaccine at reducing adverse events in patients with heart failure: a systematic review and meta-analysis
2022
Abstract: The association between influenza and adverse vascular events in patients with heart failure is well documented. The effect of influenza vaccine on preventing such adverse events is uncertain. This systematic review and meta-analysis addressed whether ... ...
| Abstract | The association between influenza and adverse vascular events in patients with heart failure is well documented. The effect of influenza vaccine on preventing such adverse events is uncertain. This systematic review and meta-analysis addressed whether vaccination against influenza reduces adverse vascular events and mortality in heart failure patients. Databases (MEDLINE and EMBASE) were searched using keywords, study screening and quality assessment were completed, and data was synthesized. Eligible studies investigated adults with heart failure who received the influenza vaccine, and reported outcomes within 12 months, compared to heart failure patients who did not receive the influenza vaccine. The following 6 outcomes were assessed: all-cause mortality, cardiovascular-related mortality, all-cause hospitalization, cardiovascular-related hospitalization, non-fatal myocardial infarction, and non-fatal stroke. Risk of bias was assessed using the Newcastle-Ottawa Scale, and a GRADE assessment was done. A random-effects meta-analysis was performed to estimate the pooled risk ratio (RR), 95% confidence interval (CI), and heterogeneity using I² statistics. After synthesizing data from 7 non-randomized studies (247,842 patients), the results demonstrate that the risk of all-cause mortality is significantly reduced within 12 months of a heart failure patient receiving the influenza vaccine (RR = 0.75, 95% CI 0.71-0.79); very low certainty of evidence. Additionally, the risk of cardiovascular-related mortality was significantly reduced (RR= 0.77, 95% CI 0.73-0.81); low certainty of evidence. The pooled risk of all-cause hospitalization was higher among vaccinated heart failure patients (RR = 1.24, 95% CI 1.13-1.35); very low certainty of evidence and considerable heterogeneity (I²=90%). No eligible studies assessed cardiovascular-related hospitalization, non-fatal myocardial infarction, and non-fatal stroke. Influenza vaccination appears to reduce adverse cardiovascular events, although the certainty of the evidence is low or very low. Rigorous randomized controlled trial evidence is needed to further examine the protective effect of the influenza vaccine in heart failure patients. |
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| Keywords | confidence interval ; heart failure ; influenza ; influenza vaccination ; influenza vaccines ; meta-analysis ; mortality ; myocardial infarction ; patients ; protective effect ; randomized clinical trials ; relative risk ; stroke ; systematic review |
| Language | English |
| Dates of publication | 2022-0411 |
| Publishing place | Elsevier Ltd |
| Document type | Article |
| Note | Pre-press version |
| ZDB-ID | 605674-x |
| ISSN | 1873-2518 ; 0264-410X |
| ISSN (online) | 1873-2518 |
| ISSN | 0264-410X |
| DOI | 10.1016/j.vaccine.2022.04.039 |
| Database | NAL-Catalogue (AGRICOLA) |
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