title: Use of oseltamivir after influenza infection is associated with reduced incidence of recurrent adverse cardiovascular outcomes among military health system beneficiaries with prior cardiovascular diseases.
abstract: BACKGROUND
  Influenza infection has been associated with increased risk of adverse cardiac and cerebral vascular outcomes. Oseltamivir, a treatment for influenza, has been shown to decrease the severity of an influenza episode, but few data exist regarding its potentially protective effect against recurrent vascular outcomes among influenza patients with a history of vascular disease.
  
  
  RESULTS
  Electronic healthcare service and pharmacy records for 37,482 TRICARE beneficiaries, aged 18 and older, with a coded history of cardiovascular (CV) disease and a subsequent diagnosis of influenza from October 1, 2003, through September 30, 2007, were examined. Subjects were grouped according to whether they had filled a prescription for oseltamivir within 2 days of their influenza diagnosis. The incidence of recurrent CV events within 30 days after the influenza diagnosis among oseltavmivir-treated and untreated subjects was 8.5% and 21.2%, respectively (P<0.005). Subject age was a persistent and significant contributor to the likelihood of recurrent CV outcomes. After controlling for the differences in demographics among treated and untreated cohorts using a propensity-scored logistic regression model, a statistically significant protective effect was associated with oseltamivir treatment (odds ratio, 0.417; 95% CI, 0.349 to 0.498).
  
  
  CONCLUSIONS
  Our findings suggests that oseltamivir treatment for influenza is associated with significant decrease in the risk of recurrent CV events in subjects with a history of CV disease. These findings merit confirmation in further prospective and controlled studies. Meanwhile, in patients with CV disease, strict adherence with current practice guidelines for prevention and treatment of influenza is recommended.
authors.affiliation: Health Affairs, TRICARE Management Activity, West Falls Church, Va., USA.
authors.forename: S Ward
authors.initials: SW
authors.lastname: Casscells
authors.forename: Elder
authors.initials: E
authors.lastname: Granger
authors.forename: Amii M
authors.initials: AM
authors.lastname: Kress
authors.forename: Andrea
authors.initials: A
authors.lastname: Linton
authors.forename: Mohammad
authors.initials: M
authors.lastname: Madjid
authors.forename: Linda
authors.initials: L
authors.lastname: Cottrell
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007251:Influenza, Human / Q000188:drug therapy* / Q000453:epidemiology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008889:Military Personnel / Q000706:statistics & numerical data; D015999:Multivariate Analysis; D053139:Oseltamivir / Q000627:therapeutic use*; D012307:Risk Factors; D055502:Secondary Prevention; D014481:United States / Q000453:epidemiology; D037041:United States Government Agencies / Q000706:statistics & numerical data
chemical_list: D000998:Antiviral Agents; D053139:Oseltamivir