title: Influenza vaccination in secondary prevention from coronary ischaemic events in coronary artery disease: FLUCAD study.
abstract: OBJECTIVE
  To evaluate the effect of influenza vaccination on the coronary events in patients with confirmed coronary artery disease (CAD).
  
  
  RESULTS
  Randomized, double-blind, placebo controlled study. We included 658 optimally treated CAD patients; 477 men, mean age 59.9+/-10.3 years. Three hundred and twenty-five patients received the influenza vaccine, and 333 patients placebo. Median follow-up was 298 (interquartile range 263-317) days. Primary endpoint was the cardiovascular death. Its estimated 12-month cumulative event rate was 0.63% in the vaccine vs. 0.76% in controls (HR 1.06 95% CI: 0.15-7.56, P = 0.95). There were two secondary composite endpoints: (i) the MACE (cardiovascular death, myocardial infarction, coronary revascularization) tended to occur less frequently in the vaccine group vs. placebo with the event rate 3.00 and 5.87%, respectively (HR 0.54;95% CI: 0.24-1.21, P = 0.13). (ii) Coronary ischaemic event (MACE or hospitalization for myocardial ischaemia) estimated 12-month event rate was significantly lower in the vaccine group 6.02 vs. 9.97% in controls (HR 0.54; 95% CI: 0.29-0.99, P = 0.047).
  
  
  CONCLUSIONS
  In optimally treated CAD patients influenza vaccination improves the clinical course of CAD and reduces the frequency of coronary ischaemic events. Large-scale studies are warranted to evaluate the effect of influenza vaccination on cardiovascular mortality. (ClinicalTrials.gov: NCT 00371098).
authors.affiliation: Institute of Cardiology, Alpejska 42, 04-628 Warszawa, Poland. aciszewski@ikard.pl
authors.forename: Andrzej
authors.initials: A
authors.lastname: Ciszewski
authors.forename: Zofia T
authors.initials: ZT
authors.lastname: Bilinska
authors.forename: Lidia B
authors.initials: LB
authors.lastname: Brydak
authors.forename: Cezary
authors.initials: C
authors.lastname: Kepka
authors.forename: Mariusz
authors.initials: M
authors.lastname: Kruk
authors.forename: Magdalena
authors.initials: M
authors.lastname: Romanowska
authors.forename: Ewa
authors.initials: E
authors.lastname: Ksiezycka
authors.forename: Jakub
authors.initials: J
authors.lastname: Przyluski
authors.forename: Walerian
authors.initials: W
authors.lastname: Piotrowski
authors.forename: Renata
authors.initials: R
authors.lastname: Maczynska
authors.forename: Witold
authors.initials: W
authors.lastname: Ruzyllo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003324:Coronary Artery Disease / Q000401:mortality*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage*; D007251:Influenza, Human / Q000453:epidemiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality; D017202:Myocardial Ischemia / Q000401:mortality / Q000517:prevention & control
chemical_list: D007252:Influenza Vaccines