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Influenza Vaccination May Offer Protection for Patients With Heart Disease NEW YORK -- September 21, 2009 -- Influenza can trigger myocardial infarctions (MI) and cause cardiovascular death, but the influenza vaccine may offer protection for cardiac patients. Thus, more efforts are needed to encourage people with heart disease and diabetes to receive the influenza vaccination. This might be especially important with the seasonal influenza and the influenza A(H1N1) viruses circulating during the 2009-2010 influenza season. The review is published in the October edition of The Lancet Infectious Diseases. The cardiac complications of influenza infection, such as myocarditis, are well known, but the role of influenza as a trigger of MIs is unclear. However, it has been suggested that influenza might cause acute and severe inflammation, which in some patients may destabilise atherosclerotic plaques and cause clots in coronary arteries leading to MIs. To provide more evidence, Charlotte Warren-Gash and Andrew C Hayward from the UCL Centre for Infectious Disease Epidemiology, London, United Kindom, and Liam Smeeth from the London School of Hygiene and Tropical Medicine, conducted a systematic review of the evidence to examine the association between influenza and MIs or cardiovascular death, including the possible cardioprotective effects of the influenza vaccine. In total, 42 papers describing 39 studies between 1932 and 2008 were analysed. All the population-level studies examined showed a rise in deaths due to heart disease or incidence of MIs during times when the influenza virus was circulating. Indeed, the proportion of excess influenza deaths that were due to heart disease averaged 35% to 50%. Findings from a range of observational studies in different settings reported consistent associations between influenza and MIs, but a weaker association with cardiovascular death. Four out of eight observational studies also showed a protective effect against MIs or cardiovascular events in those vaccinated against influenza. In addition, 2 small randomised trials suggested that influenza vaccination reduces the risks of cardiovascular death and some cardiac events. The authors pointed out that despite being the only major respiratory virus for which effective preventive vaccination is available, there is suboptimum uptake especially in people who ought to have the influenza vaccinations such as those with chronic diseases including heart disease. “We believe influenza vaccination should be encouraged wherever indicated, especially in those people with existing cardiovascular disease…Further evidence is needed on the effectiveness of influenza vaccines to reduce the risk of cardiac events in people without established vascular disease,” the authors concluded. SOURCE: The Lancet Infectious Diseases E-mail this page to a friend or colleague! To print, use this version