Abstract 10416: Influenza Vaccine Among Patients With Coronary Artery Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Studies

Abstract

Introduction: Trials evaluating the efficacy of influenza vaccine in secondary prevention among patients with prior coronary artery disease (CAD) have yielded mixed results. We sought to evaluate the efficacy of influenza vaccine in reducing cardiovascular events among patients with prior CAD. Methods: MEDLINE, EMBASE, and Cochrane databases were searched without restrictions through March 2022 for Randomized Controlled Trials (RCTs) that evaluated the outcomes of influenza vaccine versus control in patients with prior CAD. We conducted a pairwise meta-analysis comparing outcomes among the influenza vaccine. The primary outcome was all-cause mortality. Results: The final analysis included 5 trials with a total of 4,187 patients and the weighted median follow-up duration was 12 months. The influenza vaccine group was associated with 46% relative risk [RR] reduction in all-cause mortality compared with control group. (2.8% vs. 5.1%; RR 0.56; 95% confidence interval [CI] 0.41-0.76; I 2 =0%). The influenza vaccine group was also associated with lower composite of MACE (6.3% vs. 9.9%; RR 0.63; 95% CI 0.52-0.78), and cardiovascular mortality (2.5% vs. 4.7%; RR 0.54; 95% CI 0.39-0.74). There was no significant difference among both groups in acute myocardial infarction (MI) (RR 0.77; 95% CI 0.53-1.13), ischemia—driven revascularization (RR 0.89; 95% CI 0.52-1.53) and hospitalization for heart failure (RR 0.91; 95% CI 0.91 0.21-4.00). Conclusion: a meta-analysis of RCTs showed that influenza vaccine was associated with lower major adverse cardiac events (MACE), all-cause mortality, and cardiovascular mortality in patients with prior CAD. Further efforts are warranted to improve influenza vaccination rate in patients with CAD.