Siriwardena, A. Niroshan and Gwini, Stella May and Coupland, Carol (2010) Influenza vaccination, pneumococcal vaccination and risk of acute myocardial infarction: matched case–control study. Canadian Medical Association Journal, 182 (15). pp. 1-7. ISSN 0820-3946
Full content URL: http://www.cmaj.ca/cgi/content/abstract/cmaj.09189...
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Background: Previous studies have shown an association
between acute myocardial infarction and preceding respiratory infection. Contradictory evidence exists on the influence of influenza vaccination and pneumococcal vaccination in preventing cardiovascular disease. We aimed to investigate the possible association of influenza vaccination and pneumococcal vaccination with acute myocardial infarction.
Methods: We used a matched case–control design with data from the United Kingdom General Practice Research Database. Cases were patients who were at least 40 years of age at diagnosis of first acute myocardial infarction recorded from Nov.1, 2001, to May 31, 2007, and were matched for sex, general practice, age and calendar time (i.e., month corresponding to index date of acute myocardial infarction), with up to four controls each. Data were analyzed using conditional logistic regression, adjusted for
vaccination target groups, cardiovascular risk factors, treatment medications and attendances at a general practice.
Results: We included 78 706 patients, of whom 16 012 were cases and 62 694 were matched controls. Influenza vaccination had been received in the previous year by 8472 cases (52.9%) and 32 081 controls (51.2%) and was associated
with a 19% reduction in the rate of acute myocardial infarction (adjusted odds ratio [OR] 0.81, 95% confidence
interval [CI] 0.77–0.85). Early seasonal influenza vaccination was associated with a lower rate of acute myocardial infarction (adjusted OR 0.79, 95% CI 0.75–0.83) than vaccination after mid-November (adjusted OR 0.88, 95% CI 0.79–0.97). Pneumococcal vaccination was not associated with a reduction in the rate of acute myocardial infarction (adjusted OR 0.96, 95% CI 0.91–1.02).
Interpretation: Influenza vaccination but not pneumococcal
vaccination is associated with a reduced rate of first
acute myocardial infarction. This association and the potential benefit of early seasonal vaccination need to be
considered in future experimental studies.
|Keywords:||influenza vaccination, pneumococcal vaccination, acute myocardial infarction, cardiovascular disease, case control study, influenza|
|Subjects:||A Medicine and Dentistry > A300 Clinical Medicine|
|Divisions:||College of Social Science > School of Health & Social Care|
|Deposited On:||03 Oct 2010 19:34|
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