Influenza vaccination and in-hospital mortality in patients with acute myocardial infarction with history of prior PCI or CABG: a nationwide cohort analysis

Abstract

Abstract Introduction Influenza vaccination is associated with lower risk of death as well as major adverse cardiovascular events, including acute myocardial infarction (AMI), heart failure and stroke. Purpose The impact of Influenza vaccination on in-hospital mortality in patients with AMI with a prior history of percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) is largely unknown. We hypothesize that such individuals who develop AMI have better outcomes if they had received influenza vaccine. Methods We analyzed the United States National Inpatient Sample Database from 2010–2014 to identify patients with primary discharge diagnosis of AMI (STEMI, NSTEMI) with a history of prior PCI or CABG. In this cohort, patients with influenza vaccination were identified using ICD-9 code V04.81. The primary outcome was in-hospital mortality. Chi-square test and multivariate regression model controlling for age, gender, race, type of AMI and co-morbidities were employed for statistical analysis. Results A total of 495,619 patients with ACS were identified who had prior PCI or CABG and 6525 had positive influenza vaccination status. Influenza vaccination was independently associated with lower risk of in-hospital mortality in patients with AMI (aOR = 0.253, 95% CI: 0.196–0.328; p<0.001). Conclusion Vaccination against influenza was associated with lower risk of in-hospital mortality in patients with prior PCI or CABG who developed AMI. Figure 1 Funding Acknowledgement Type of funding source: None