Influenza vaccination: a call for cardiologists.
Influenza vaccination: a call for cardiologists.
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流感疫苗接种：呼吁心脏病专家。
DOI：
10.1093/eurjpc/zwac196
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发表时间：
2022
影响因子：
8.3
通讯作者：
Martin,SethS
中科院分区：
文献类型：
--
作者：
Kim,ChangH;Marvel,FrancoiseA;Martin,SethS
季节性流感与心血管发病率和死亡率风险升高之间的相关性已得到充分证实。1流感感染导致全身炎症状态，可通过促血栓形成活性和血流动力学失衡引发心血管事件。2为减轻流感及相关疾病的健康负担，世界各地的专业团体及医疗机构均建议接种流感疫苗，并特别重视患上严重疾病的高危病人，包括患有慢性心血管疾病的病人。3，4尽管有这些建议，流感疫苗接种率在那些既存心血管疾病的人群中仍然不理想。5，6之前的汇总分析通常显示，流感疫苗接种在全因死亡率（ACM）、心血管死亡率（CVM）和主要不良心血管事件（MACE）方面具有保护作用，7，8尽管特定患者人群和个体心血管事件的风险估计有所不同。根据最近完成的两项大型跨国随机对照试验，9，10 Jaiswal等人的系统综述和荟萃分析，11发表在本期杂志上，及时更新了合并证据库，阐述了流感疫苗接种对心血管疾病确诊或高危患者的心血管效应。分析了18项研究（5项随机临床试验和13项观察性研究），共2230万例受试者。其中，217 072人（111 073人接种疫苗，105 999人未接种疫苗）属于心血管高危组，并纳入主要分析。入选标准为年龄≥ 18岁，有明确的心血管疾病[定义为心肌梗死（MI）、卒中或心力衰竭（HF）病史]或高风险（定义为存在心血管风险因素，如高血压、高脂血症、糖尿病或吸烟）。疫苗接种状态不按疫苗亚型区分，
The association between seasonal influenza and elevated risk of cardiovascular morbidity and mortality is well established. 1 Infection with influenza leads to a systemic inflammatory state that can trigger cardiovascular events through prothrombotic activity and hemodynamic imbalances. 2 To reduce the health burden associated with influenza and related illness, influenza vaccination is recommended by professional societies and healthcare organizations worldwide, with particular importance given to patient groups at high risk of severe illness including those with chronic cardiovascular disease. 3, 4 Despite these recommendations, influenza vaccination rates remain suboptimal among those with pre-existing cardiovascular disease. 5, 6 Prior pooled analyses have generally shown a protective effect of influenza vaccination in terms of all-cause mortality (ACM), cardiovascular mortality (CVM), and major adverse cardiovascular events (MACEs), 7, 8 although risk estimates have varied for specific patient populations and individual cardiovascular events. In light of two recently completed large, multi-national randomized controlled trials, 9, 10 the systematic review and meta-analysis by Jaiswal et al. 11, published in this issue of the Journal, provides a timely update to the pooled evidence base addressing the cardiovascular effects of influenza vaccination in patients with established or at high risk of cardiovascular disease.The authors performed a systematic review and meta-analysis of 18 studies (5 randomized clinical trials and 13 observational studies) with 22.3 million total participants. Among them, 217 072 (111073 vaccinated and 105 999 unvaccinated) were in the high cardiovascular risk group and included in the primary analysis. Inclusion criteria were age≥ 18 years with established cardiovascular disease [defined as history of myocardial infarction (MI), stroke, or heart failure (HF)] or at high risk (defined by the presence of cardiovascular risk factor (s) such as hypertension, hyperlipidemia, diabetes, or smoking). Vaccination status was not distinguished by vaccine subtype and