Heart failure patients vaccinated against influenza are at a significantly lower risk of dying, both during flu season and outside of it.

Patients with heart failure vaccinated had a 48% lower risk of death during influenza season and a 21% lower risk during the rest of the year.

Dr. Fukuta, lead investigator in this study, explained that flu vaccination of heart failure patients in Japan is not formally recommended. Larger-scale and adequately powered randomized controlled trials, such as INVESTED, will provide a definitive answer.

At the moment, with some inconsistent results, we must settle for this meta-analysis led by Dr. Fukuta, which includes 5 observational studies involving a total of 78,882 patients with heart failure. The age of patients ranged from 64 to 75 years old, and study follow-up was between 1 and 4 years.

Read also: ACC 2018 | Risk of MI in Non-Cardiac Surgeries.

There are physiopathologic reasons supporting vaccination, such as the fact that respiratory infections (including influenza) are the precipitating cause of heart failure and are associated with increased mortality. If vaccination reduces the incidence and/or severity of these respiratory infections, it will prevent heart failure exacerbations, hospitalization, and associated mortality.

Furthermore, vaccination reduces the risk of cardiovascular events, including infarction and unstable angina, in patients with coronary artery disease. There are studies showing a sixfold higher risk of infarction in the week after a flu diagnosis. In such cases, physiopathology is probably related to inflammation.

Original title: The Effect of Influenza Vaccination on Mortality and Hospitalization in Patients with Heart Failure: A Meta-Analysis.

Presenter: Fukuta H.

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