TY - JOUR
T1 - Optimal timing of influenza vaccination among patients with acute myocardial infarction - Findings from the IAMI trial
AU - Akhtar, Zubair
AU - Götberg, Matthias
AU - Erlinge, David
AU - Christiansen, Evald H
AU - Oldroyd, Keith G
AU - Motovska, Zuzana
AU - Erglis, Andrejs
AU - Hlinomaz, Ota
AU - Jakobsen, Lars
AU - Engstrøm, Thomas
AU - Jensen, Lisette O
AU - Fallesen, Christian O
AU - Jensen, Svend E
AU - Angerås, Oskar
AU - Calais, Fredrik
AU - Kåregren, Amra
AU - Lauermann, Jörg
AU - Mokhtari, Arash
AU - Nilsson, Johan
AU - Persson, Jonas
AU - Islam, Abu K M M
AU - Rahman, Afzalur
AU - Malik, Fazila
AU - Choudhury, Sohel
AU - Collier, Timothy
AU - Pocock, Stuart J
AU - Pernow, John
AU - MacIntyre, Chandini R
AU - Fröbert, Ole
PY - 2023/11
Y1 - 2023/11
N2 - Influenza vaccination reduces the risk of adverse cardiovascular events.The IAMI trial randomly assigned 2571 patients with acute myocardial infarction (AMI) to receive influenza vaccine or saline placebo during their index hospital admission. It was conducted at 30 centers in 8 countries from October 1, 2016 to March 1, 2020. In this post-hoc exploratory sub-study, we compare the trial outcomes in patients receiving early season vaccination (n = 1188) and late season vaccination (n = 1344).The primary endpoint wasthe composite of all-cause death, myocardial infarction (MI), or stent thrombosis at 12 months. Thecumulative incidence of the primary and key secondary endpoints by randomized treatment and early or late vaccination was estimated using the Kaplan-Meier method. In the early vaccinated group, the primary composite endpoint occurred in 36 participants (6.0%) assigned to influenza vaccine and 49 (8.4%) assigned to placebo (HR 0.69; 95% CI 0.45 to 1.07), compared to 31 participants (4.7%) assigned to influenza vaccine and 42 (6.2%) assigned to placebo (HR 0.74; 95% CI 0.47 to 1.18) in the late vaccinated group (P = 0.848 for interaction on HR scale at 1 year). We observed similar estimates for the key secondary endpoints of all-cause death and CV death. There was no statistically significant difference in vaccine effectiveness against adverse cardiovascular events by timing of vaccination. The effect of vaccination on all-cause death at one year was more pronounced in the group receiving early vaccination (HR 0.50; 95% CI, 0.29 to 0.86) compared late vaccination group (HR 0.75; 35% CI, 0.40 to 1.40) but there was no statistically significant difference between these groups (Interaction P = 0.335). In conclusion,there is insufficient evidence from the trial to establish whether there is a difference in efficacy between early and late vaccinationbut regardless of vaccination timing we strongly recommend influenza vaccination in all patients with cardiovascular diseases.
AB - Influenza vaccination reduces the risk of adverse cardiovascular events.The IAMI trial randomly assigned 2571 patients with acute myocardial infarction (AMI) to receive influenza vaccine or saline placebo during their index hospital admission. It was conducted at 30 centers in 8 countries from October 1, 2016 to March 1, 2020. In this post-hoc exploratory sub-study, we compare the trial outcomes in patients receiving early season vaccination (n = 1188) and late season vaccination (n = 1344).The primary endpoint wasthe composite of all-cause death, myocardial infarction (MI), or stent thrombosis at 12 months. Thecumulative incidence of the primary and key secondary endpoints by randomized treatment and early or late vaccination was estimated using the Kaplan-Meier method. In the early vaccinated group, the primary composite endpoint occurred in 36 participants (6.0%) assigned to influenza vaccine and 49 (8.4%) assigned to placebo (HR 0.69; 95% CI 0.45 to 1.07), compared to 31 participants (4.7%) assigned to influenza vaccine and 42 (6.2%) assigned to placebo (HR 0.74; 95% CI 0.47 to 1.18) in the late vaccinated group (P = 0.848 for interaction on HR scale at 1 year). We observed similar estimates for the key secondary endpoints of all-cause death and CV death. There was no statistically significant difference in vaccine effectiveness against adverse cardiovascular events by timing of vaccination. The effect of vaccination on all-cause death at one year was more pronounced in the group receiving early vaccination (HR 0.50; 95% CI, 0.29 to 0.86) compared late vaccination group (HR 0.75; 35% CI, 0.40 to 1.40) but there was no statistically significant difference between these groups (Interaction P = 0.335). In conclusion,there is insufficient evidence from the trial to establish whether there is a difference in efficacy between early and late vaccinationbut regardless of vaccination timing we strongly recommend influenza vaccination in all patients with cardiovascular diseases.
KW - Humans
KW - Influenza Vaccines
KW - Influenza, Human/prevention & control
KW - Myocardial Infarction
KW - Thrombosis
KW - Vaccination/methods
KW - Myocardial infarction
KW - Vaccine effectiveness
KW - Percutaneous coronary intervention
KW - Influenza vaccination
KW - Optimal timing
UR - http://www.scopus.com/inward/record.url?scp=85176266634&partnerID=8YFLogxK
U2 - 10.1016/j.vaccine.2023.10.028
DO - 10.1016/j.vaccine.2023.10.028
M3 - Journal article
C2 - 37925315
SN - 0264-410X
VL - 41
SP - 7159
EP - 7165
JO - Vaccine
JF - Vaccine
IS - 48
ER -