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Review
Influenza vaccine as a coronary intervention for prevention of myocardial infarction
  1. C Raina MacIntyre1,2,
  2. Abela Mahimbo1,
  3. Aye M Moa1,
  4. Michelle Barnes1
  1. 1School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
  2. 2College of Public Service & Community Solutions, Arizona State University, Phoenix, Arizona, USA
  1. Correspondence to Professor C Raina MacIntyre, School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, Sydney 2052, Australia; r.macintyre{at}unsw.edu.au

Abstract

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.

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/heartjnl-2016-309983

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    Footnotes

    • Contributors CRM: conceived study idea, wrote and revised the manuscript. AM: conducting literature review and drafting of manuscript. AMM: contributed to revision and submission of manuscript. MB: contributed to drafting of manuscript.

    • Competing interests CRM has received in-kind support and funding for investigator-driven research from GlaxoSmithKline, Pfizer, Merck and bioCSL, and has sat on advisory boards for Merck, GlaxoSmithKline and Pfizer.

    • Provenance and peer review Not commissioned; externally peer reviewed.