Influenza vaccine as a coronary intervention for prevention of myocardial infarction.
Influenza vaccine as a coronary intervention for prevention of myocardial infarction.
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流感疫苗作为预防心肌梗塞的冠状动脉干预。
DOI：
10.1136/heartjnl-2016-309983
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发表时间：
2016-12-15
期刊：
影响因子：
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通讯作者：
Barnes M
中科院分区：
文献类型：
--
作者：
MacIntyre CR;Mahimbo A;Moa AM;Barnes M
心血管疾病（CVD）是全球发病率和死亡率的主要原因。流感是全球发病率和死亡率的主要传染性原因之一，并且越来越多的证据表明它可以促成急性心肌梗死（AMI）。这被认为是由于一系列因素，包括细胞因子的炎性释放、动脉粥样硬化斑块的破坏和血栓形成，其可能急性阻塞冠状动脉。有大量的观察和临床试验证据表明，流感疫苗可以预防AMI。流感疫苗预防AMI的有效性估计为15%至45%。这与公认的常规冠状动脉预防措施（如戒烟（32-43%）、他汀类药物（19-30%）和降压治疗（17-25%））的疗效范围相似。流感疫苗应被视为心血管疾病管理和预防的一个组成部分。虽然许多指南建议CVD患者接种疫苗，但年龄<65岁的风险群体的疫苗接种率非常低，在30%的范围内。 将疫苗接种纳入患者护理中的常规CVD预防需要临床实践范式的改变。
Cardiovascular disease (CVD) is the leading cause of morbidity and mortality globally. Influenza is one of the leading infectious causes of morbidity and mortality globally, and evidence is accumulating that it can precipitate acute myocardial infarction (AMI). This is thought to be due to a range of factors including inflammatory release of cytokines, disruption of atherosclerotic plaques and thrombogenesis, which may acutely occlude a coronary artery. There is a large body of observational and clinical trial evidence that shows that influenza vaccine protects against AMI. Estimates of the efficacy of influenza vaccine in preventing AMI range from 15% to 45%. This is a similar range of efficacy compared with the accepted routine coronary prevention measures such as smoking cessation (32–43%), statins (19–30%) and antihypertensive therapy (17–25%). Influenza vaccine should be considered as an integral part of CVD management and prevention. While it is recommended in many guidelines for patients with CVD, rates of vaccination in risk groups aged <65 years are very low, in the range of 30%. The incorporation of vaccination into routine CVD prevention in patient care requires a clinical practice paradigm change.