Influenza vaccination in secondary prevention from coronary ischaemic events in coronary artery disease: FLUCAD study.
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).
Ciszewski
Andrzej
A
Institute of Cardiology, Alpejska 42, 04-628 Warszawa, Poland. aciszewski@ikard.pl
Bilinska
Zofia T
ZT
Brydak
Lidia B
LB
Kepka
Cezary
C
Kruk
Mariusz
M
Romanowska
Magdalena
M
Ksiezycka
Ewa
E
Przyluski
Jakub
J
Piotrowski
Walerian
W
Maczynska
Renata
R
Ruzyllo
Witold
W
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
D007252:Influenza Vaccines