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Clinical impact of influenza vaccination after ST- and non-ST-segment elevation myocardial infarction - insights from the IAMI trial

O. Fröbert, M. Götberg, D. Erlinge, Z. Akhtar, EH. Christiansen, CR. MacIntyre, KG. Oldroyd, Z. Motovska, A. Erglis, R. Moer, O. Hlinomaz, L. Jakobsen, T. Engstrøm, LO. Jensen, CO. Fallesen, SE. Jensen, O. Angerås, F. Calais, A. Kåregren, J....

. 2023 ; 255 (-) : 82-89. [pub] 20221021

Jazyk angličtina Země Spojené státy americké

Typ dokumentu randomizované kontrolované studie, časopisecké články

Perzistentní odkaz   https://www.medvik.cz/link/bmc22032047
E-zdroje Online Plný text

NLK ProQuest Central od 2002-01-01 do Před 2 měsíci
Nursing & Allied Health Database (ProQuest) od 2002-01-01 do Před 2 měsíci
Health & Medicine (ProQuest) od 2002-01-01 do Před 2 měsíci
Health Management Database (ProQuest) od 2002-01-01 do Před 2 měsíci
Public Health Database (ProQuest) od 2002-01-01 do Před 2 měsíci

BACKGROUND: Influenza vaccination early after myocardial infarction (MI) improves prognosis but vaccine effectiveness may differ dependent on type of MI. METHODS: A total of 2,571 participants were prospectively enrolled in the Influenza vaccination after myocardial infarction (IAMI) trial and randomly assigned to receive in-hospital inactivated influenza vaccine or saline placebo. The trial was conducted at 30 centers in eight countries from October 1, 2016 to March 1, 2020. Here we report vaccine effectiveness in the 2,467 participants with ST-segment elevation MI (STEMI, n = 1,348) or non-ST-segment elevation MI (NSTEMI, n = 1,119). The primary endpoint was the composite of all-cause death, MI, or stent thrombosis at 12 months. Cumulative incidence of the primary and key secondary endpoints by randomized treatment and NSTEMI/STEMI was estimated using the Kaplan-Meier method. Treatment effects were evaluated with formal interaction testing to assess for effect modification. RESULTS: Baseline risk was higher in participants with NSTEMI. In the NSTEMI group the primary endpoint occurred in 6.5% of participants assigned to influenza vaccine and 10.5% assigned to placebo (hazard ratio [HR], 0.60; 95% CI, 0.39-0.91), compared to 4.1% assigned to influenza vaccine and 4.5% assigned to placebo in the STEMI group (HR, 0.90; 95% CI, 0.54-1.50, P = .237 for interaction). Similar findings were seen for the key secondary endpoints of all-cause death and cardiovascular death. The Kaplan-Meier risk difference in all-cause death at one year was more pronounced in participants with NSTEMI (NSTEMI: HR, 0.47; 95% CI 0.28-0.80, STEMI: HR, 0.86; 95% CI, 0.43-1.70, interaction P = .028). CONCLUSIONS: The beneficial effect of influenza vaccination on adverse cardiovascular events may be enhanced in patients with NSTEMI compared to those with STEMI.

Cardiocenter 3rd Faculty of Medicine Charles University Prague Czech Republic and University Hospital Kralovske Vinohrady Prague Bohemia Czech Republic

Cardiology Heart Centre Department of Public Health and Clinical Medicine Umeå University Umea Västerbotten län Sweden

Cardiology Unit Department of Medicine Solna Karolinska Institutet and Karolinska University Hospital Stockholm Stockholm Sweden

Department of Cardiology Aalborg University Hospital Aalborg Denmark and Department of Clinical Medicine Aalborg University Aalborg Kommune Denmark

Department of Cardiology Aarhus University Hospital Aarhus Aarhus Denmark

Department of Cardiology Jönköping Region Jönköping County and Department of Health Medicine and Caring Linköping University Linköping Östergötland Sweden

Department of Cardiology Karlstad Central Hospital Karlstad Värmland Sweden

Department of Cardiology Odense University Hospital Odense Odense Denmark

Department of Cardiology Skane University Hospital Clinical Sciences Lund University Lund Scania Sweden

Department of Medical Statistics London School of Hygiene and Tropical Medicine London London United Kingdom

Division of Cardiovascular Medicine Department of Clinical Sciences Karolinska Institutet Danderyd University Hospital Stockholm Södermanland and Uppland Sweden

Institute of Cardiovascular and Medical Sciences University of Glasgow United Kingdom and West of Scotland Heart and Lung Centre Golden Jubilee National Hospital Clydebank Glasgow Scotland United Kingdom

International Centre for Diarrhoeal Disease Research Bangladesh Dhaka Dhaka Bangladesh

LHL sykehuset Gardermoen Oslo Ostiandet Norway

National Heart Foundation Hospital and Research Institute Dhaka Dhaka Bangladesh

National Institute of Cardiovascular Diseases Sher e Bangla Nagar Dhaka Dhaka Bangladesh

Örebro University Faculty of Health Department of Cardiology Örebro Örebro Sweden

Pauls Stradins Clinical University Hospital University of Latvia Riga Riga Latvia

Rigshospitalet University of Copenhagen Copenhagen Copenhagen Denmark

Sahlgrenska University Hospital Gothenburg Sweden and Institute of Medicine Department of molecular and clinical medicine Gothenburg University Gothenburg Västergötland Sweden

ternational clinical research center St Anne University Hospital and Masaryk University Brno South Moravian Czech Republic

The Kirby Institute UNSW Medicine University of New South Wales Sydney New South Wales Australia

Västmanlands sjukhus Västerås Västerås Västmanland Sweden

Citace poskytuje Crossref.org

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$a BACKGROUND: Influenza vaccination early after myocardial infarction (MI) improves prognosis but vaccine effectiveness may differ dependent on type of MI. METHODS: A total of 2,571 participants were prospectively enrolled in the Influenza vaccination after myocardial infarction (IAMI) trial and randomly assigned to receive in-hospital inactivated influenza vaccine or saline placebo. The trial was conducted at 30 centers in eight countries from October 1, 2016 to March 1, 2020. Here we report vaccine effectiveness in the 2,467 participants with ST-segment elevation MI (STEMI, n = 1,348) or non-ST-segment elevation MI (NSTEMI, n = 1,119). The primary endpoint was the composite of all-cause death, MI, or stent thrombosis at 12 months. Cumulative incidence of the primary and key secondary endpoints by randomized treatment and NSTEMI/STEMI was estimated using the Kaplan-Meier method. Treatment effects were evaluated with formal interaction testing to assess for effect modification. RESULTS: Baseline risk was higher in participants with NSTEMI. In the NSTEMI group the primary endpoint occurred in 6.5% of participants assigned to influenza vaccine and 10.5% assigned to placebo (hazard ratio [HR], 0.60; 95% CI, 0.39-0.91), compared to 4.1% assigned to influenza vaccine and 4.5% assigned to placebo in the STEMI group (HR, 0.90; 95% CI, 0.54-1.50, P = .237 for interaction). Similar findings were seen for the key secondary endpoints of all-cause death and cardiovascular death. The Kaplan-Meier risk difference in all-cause death at one year was more pronounced in participants with NSTEMI (NSTEMI: HR, 0.47; 95% CI 0.28-0.80, STEMI: HR, 0.86; 95% CI, 0.43-1.70, interaction P = .028). CONCLUSIONS: The beneficial effect of influenza vaccination on adverse cardiovascular events may be enhanced in patients with NSTEMI compared to those with STEMI.
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