The risk for all-cause mortality among patients with pre-existing heart failure was 31% less in patients who received the influenza vaccine than in those were not vaccinated, according to findings from a systematic review and meta-analysis published in Open Forum Infectious Diseases.
It is well-documented that influenza vaccination can reduce influenza-related hospitalization and death, especially among populations at a greater risk for complications, such as pregnant women, older adults and patients with heart failure.
“Reports have suggested a protective role of influenza vaccination on the prognosis of patients with heart failure, but no large randomized controlled trials or a meta-analysis have been conducted to quantitatively estimate the effectiveness of influenza vaccination on patients with heart failure,” Sanjay Poudel, MBBS, from the Warren Alpert Medical School of Brown University, and colleagues wrote.
Poudel and colleagues searched PubMed and EMBASE for studies published from January 2000 through April 2018 and used them to evaluate the impact of vaccination in this population. They also examined the effect of vaccination during influenza seasons compared with noninfluenza seasons.
According to the study, 82,354 patients with heart failure were identified across eight studies. The mean age of patients was 65 years or older in seven of the eight studies.
Poudel and colleagues reported observing a reduced risk for all-cause mortality among patients with heart failure who were vaccinated against influenza (HR = 0.69; 95% CI, 0.51-0.87). Data showed the effect was more prominent during influenza seasons (HR = 0.49; 95% CI, 0.3-0.69) compared with noninfluenza seasons (HR = 0.79; 95% CI, 0.68-0.89).
The researchers did not find a statistically significant difference in heart failure hospitalizations between patients who received an influenza vaccination and those who did not (HR = 0.62; 95% CI, 0-1.23). They explained that this might be “due to the relatively limited number of studies.”
They recommended implementing stricter influenza vaccination strategies among patients with heart failure.
“Future studies should focus on identifying subgroups of patients who are less likely to be vaccinated, the effectiveness of high-dose vaccines and the subgroups that can have the highest benefit,” Poudel and colleagues wrote. “Also, an updated cost-effectiveness analysis should incorporate the potential benefit from the influenza vaccination, current practices, and the possible decrease in health care cost.” – by Marley Ghizzone
Disclosures: Poudel reports no relevant financial disclosure. Please see the study for all other authors’ relevant financial disclosures.