447 Attitudes of Healthcare Workers Towards Influenza Vaccination and Its Impact on Patients With Acute Myocardial Infarction

Abstract Introduction Influenza vaccination is associated with lower risk of death as well as major adverse cardiovascular events, including acute myocardial infarction (AMI), heart failure and stroke. Purpose The impact of Influenza vaccination on in-hospital mortality in patients with AMI with a prior history of percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) is largely unknown. We hypothesize that such individuals who develop AMI have better outcomes if they had received influenza vaccine. Methods We analyzed the United States National Inpatient Sample Database from 2010–2014 to identify patients with primary discharge diagnosis of AMI (STEMI, NSTEMI) with a history of prior PCI or CABG. In this cohort, patients with influenza vaccination were identified using ICD-9 code V04.81. The primary outcome was in-hospital mortality. Chi-square test and multivariate regression model controlling for age, gender, race, type of AMI and co-morbidities were employed for statistical analysis. Results A total of 495,619 patients with ACS were identified who had prior PCI or CABG and 6525 had positive influenza vaccination status. Influenza vaccination was independently associated with lower risk of in-hospital mortality in patients with AMI (aOR = 0.253, 95% CI: 0.196–0.328; p<0.001). Conclusion Vaccination against influenza was associated with lower risk of in-hospital mortality in patients with prior PCI or CABG who developed AMI. Figure 1 Funding Acknowledgement Type of funding source: None

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Influenza vaccine and risk of acute myocardial infarction in a population-based case–control study

Heart ◽

10.1136/heartjnl-2021-319754 ◽

2021 ◽

pp. heartjnl-2021-319754

Author(s):

Francisco José de Abajo ◽

Sara Rodríguez-Martín ◽

Diana Barreira ◽

Antonio Rodríguez-Miguel ◽

Encarnación Fernández-Antón ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

General Population ◽

Influenza Vaccine ◽

Influenza Vaccination ◽

Index Date ◽

Case Control Study ◽

Population Based ◽

Case Control ◽

Control Study

ObjectiveTo assess the relationship between influenza vaccination and risk of a first acute myocardial infarction (AMI) in the general population by different epidemic periods.MethodsThis is a population-based case–control study carried out in BIFAP (Base de datos para la investigación farmacoepidemiológica en atención primaria), over 2001–2015, in patients aged 40–99 years. Per each incident AMI case, five controls were randomly selected, individually matched for exact age, sex and index date (AMI diagnosis). A patient was considered vaccinated when he/she had a recorded influenza vaccination at least 14 days before the index date within the same season. The association between influenza vaccination and AMI risk was assessed through a conditional logistic regression, computing adjusted ORs (AOR) and their respective 95% CIs. The analysis was performed overall and by each of the three time epidemic periods per study year (pre-epidemic, epidemic and postepidemic).ResultsWe identified 24 155 AMI cases and 120 775 matched controls. Of them, 31.4% and 31.2%, respectively, were vaccinated, yielding an AOR of 0.85 (95% CI 0.82 to 0.88). No effect modification by sex, age and background cardiovascular risk was observed. The reduced risk of AMI was observed shortly after vaccination and persisted over time. Similar results were obtained during the pre-epidemic (AOR=0.87; 95% CI 0.79 to 0.95), epidemic (AOR=0.89; 95% CI 0.82 to 0.96) and postepidemic (AOR=0.83; 95% CI 0.79 to 0.87) periods. No association was found with pneumococcal vaccine (AOR=1.10; 95% CI 1.06 to 1.15).ConclusionsResults are compatible with a moderate protective effect of influenza vaccine on AMI in the general population, mostly in primary prevention, although bias due to unmeasured confounders may partly account for the results.

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The effect of influenza vaccination on risk of acute myocardial infarction: Self-controlled case-series study

Vaccine ◽

10.1016/j.vaccine.2010.12.017 ◽

2011 ◽

Vol 29 (6) ◽

pp. 1145-1149 ◽

Cited By ~ 39

Author(s):

Stella M. Gwini ◽

Carol A.C. Coupland ◽

Aloysius N. Siriwardena

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Influenza Vaccination ◽

Case Series ◽

Case Series Study ◽

Series Study

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Call to action: cardiologists should promote influenza vaccination

Netherlands Heart Journal ◽

10.1007/s12471-021-01637-9 ◽

2021 ◽

Author(s):

G. L. Habib ◽

H. Yousuf ◽

J. Narula ◽

L. Hofstra

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Influenza Vaccination ◽

Seasonal Influenza ◽

Cardiovascular Complications ◽

Point Of View ◽

Medical Community ◽

Call To Action ◽

Vaccine Preventable Diseases ◽

Better Than

AbstractThe COVID-19 pandemic has spurred clinical and scientific interest in the cardiology community because of the significantly enhanced vulnerability of patients with underlying cardiac diseases. COVID-19 vaccination is therefore of vital importance to the patients we see in our clinics and hospitals every day and should be promoted by the medical community, especially cardiologists. In view of vaccine-preventable diseases, the association between influenza and cardiovascular complications has been widely investigated. Several studies have found a substantially elevated risk of hospital admission for acute myocardial infarction in the first 7 days after laboratory-confirmed influenza, with incidence ratios ranging from 6.05–8.89. The effectiveness of the influenza vaccine to protect against acute myocardial infarction is about 29%. This effectiveness is comparable to or even better than that of existing secondary preventive therapies, such as statins (prevention rate approximately 36%), antihypertensives (prevention rate approximately 15–18%), and smoking cessation (prevention rate approximately 26%). As the influenza season is rapidly approaching, this Point of View article serves as a call to action: Cardiologists should promote influenza vaccination and actively advice their patients to get the seasonal influenza vaccination.

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Influenza vaccination, pneumococcal vaccination and risk of acute myocardial infarction: matched case-control study

Canadian Medical Association Journal ◽

10.1503/cmaj.091891 ◽

2010 ◽

Vol 182 (15) ◽

pp. 1617-1623 ◽

Cited By ~ 51

Author(s):

A. N. Siriwardena ◽

S. M. Gwini ◽

C. A. C. Coupland

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Influenza Vaccination ◽

Case Control Study ◽

Pneumococcal Vaccination ◽

Case Control ◽

Matched Case ◽

Matched Case Control Study ◽

Control Study

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An electron microscopic study of the intra-myocardial lesions in cases of acute myocardial infarction

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s042482010008328x ◽

1978 ◽

Vol 36 (2) ◽

pp. 484-485

Author(s):

Masahiro Ono ◽

Kaoru Aihara ◽

Gompachi Yajima

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Coronary Vessels ◽

Vascular Wall ◽

Vascular Changes ◽

Electron Microscopic ◽

Main Trunk ◽

Mechanical Destruction ◽

Transmission Electron ◽

Myocardial Lesions

The pathogenesis of the arteriosclerosis in the acute myocardial infarction is the matter of the extensive survey with the transmission electron microscopy in experimental and clinical materials. In the previous communication,the authors have clarified that the two types of the coronary vascular changes could exist. The first category is the case in which we had failed to observe no occlusive changes of the coronary vessels which eventually form the myocardial infarction. The next category is the case in which occlusive -thrombotic changes are observed in which the myocardial infarction will be taken placed as the final event. The authors incline to designate the former category as the non-occlusive-non thrombotic lesions. The most important findings in both cases are the “mechanical destruction of the vascular wall and imbibition of the serous component” which are most frequently observed at the proximal portion of the coronary main trunk.

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