| アブストラクト | AIMS: Previous studies show a reduced incidence of first myocardial infarction and stroke 1-3 months after influenza vaccination, but it is unclear how underlying cardiovascular risk impacts the association. METHODS AND RESULTS: The study used linked Clinical Practice Research Datalink, Hospital Episode Statistics Admitted Patient Care and Office for National Statistics mortality data from England between 1 September 2008 and 31 August 2019. From the data, individuals aged 40-84 years with a first acute cardiovascular event and influenza vaccination occurring within 12 months of each September were selected. Using a self-controlled case series analysis, season-adjusted cardiovascular risk stratified incidence ratios (IRs) for cardiovascular events after vaccination compared with baseline time before and >120 days after vaccination were generated. 193 900 individuals with a first acute cardiovascular event and influenza vaccine were included. 105 539 had hypertension and 172 050 had a QRISK2 score >/=10%. In main analysis, acute cardiovascular event risk was reduced in the 15-28 days after vaccination [IR 0.72 (95% CI 0.70-0.74)] and, while the effect size tapered, remained reduced to 91-120 days after vaccination [0.83 (0.81-0.88)]. Reduced cardiovascular events were seen after vaccination among individuals of all age groups and with raised and low cardiovascular risk. CONCLUSIONS: Influenza vaccine may offer cardiovascular benefit among individuals at varying cardiovascular risk. Further studies are needed to characterize the populations who could derive the most cardiovascular benefits from vaccination. |
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| 投稿者 | Davidson, Jennifer A; Banerjee, Amitava; Douglas, Ian; Leyrat, Clemence; Pebody, Richard; McDonald, Helen I; Herrett, Emily; Forbes, Harriet; Smeeth, Liam; Warren-Gash, Charlotte |
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| 組織名 | Department of Non-Communicable Disease Epidemiology, London School of Hygiene and;Tropical Medicine, Keppel Street, London WC1E 7HT, UK.;Institute of Health Informatics, University College London, 222 Euston Road,;London NW1 2DA, UK.;Department of Medical Statistics, London School of Hygiene and Tropical Medicine,;Keppel Street, London WC1E 7HT, UK.;Institute of Epidemiology and Health Care, University College London, 1-19;Torrington Place, London NW1 2DA, UK.;National Institute for Health Research Health Protection Research Unit in;Immunisation, London School of Hygiene and Tropical Medicine in partnership with;the UK Health Security Agency, Keppel Street, London WC1E 7HT, UK.;Department of Infectious Disease Epidemiology, London School of Hygiene and;Population Health Sciences, Bristol Medical School, University of Bristol, Queens;Road, Bristol BS8 1QU, UK. |
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