Clinical impact of influenza vaccination after ST- and non-ST-segment elevation myocardial infarction - insights from the IAMI trial
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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.
| Originalsprog | Engelsk |
|---|---|
| Tidsskrift | American Heart Journal |
| Vol/bind | 255 |
| Sider (fra-til) | 82-89 |
| Antal sider | 8 |
| ISSN | 0002-8703 |
| DOI | |
| Status | Udgivet - 2023 |
Bibliografisk note
Funding Information:
Funded by a grant from the Swedish Heart-Lung Foundation (project number 20150284), the Danish Heart Foundation (grant number 16-R107-A6596–22958), ALF Grants, and Nyckelfonden, Region Örebro, Sweden and by an unrestricted grant from Sanofi Pasteur, Lyon, France, who also provided the study vaccine. The authors are solely responsible for the design and implementation of this study, all study analyses, the drafting and editing of the paper, and its final content. Conflict of interest OF reports grants from Sanofi Pasteur, during the conduct of the study. TE reports personal fees from Abbott, personal fees from Bayer, personal fees from Novo Nordisk, outside the submitted work. MG reports personal fees from Boston Scientific, personal fees from Medtronic, personal fees from Abbott, outside the submitted work. CRM reports grants from Sanofi, outside the submitted work. All other authors declare no competing interests. Ole Fröbert: Conceptualization, Methodology, Validation, Writing – original draft, Investigation, Funding acquisition. Matthias Götberg: Validation, Supervision, Writing – review & editing, Investigation. David Erlinge: Validation, Supervision, Writing – review & editing, Investigation. Zubair Akhtar: Writing – review & editing, Investigation. Evald H. Christiansen: Validation, Supervision, Writing – review & editing, Investigation, Funding acquisition. Chandini R. MacIntyre: Validation, Supervision, Writing – review & editing, Investigation. Keith G. Oldroyd: Supervision, Writing – review & editing, Investigation. Zuzana Motovska: Writing – review & editing, Investigation. Andrejs Erglis: Writing – review & editing, Investigation. Rasmus Moer: Writing – review & editing¸ Investigation. Ota Hlinomaz: Writing – review & editing, Investigation. Lars Jakobsen: Writing – review & editing, Investigation. Thomas Engstrøm: Writing – review & editing, Investigation. Lisette O. Jensen: Writing – review & editing, Investigation. Christian O. Fallesen: Writing – review & editing, Investigation. Svend E Jensen: Writing – review & editing, Investigation. Oskar Angerås: Writing – review & editing, Investigation. Fredrik Calais: Writing – review & editing, Investigation. Amra Kåregren: Writing – review & editing, Investigation. Jörg Lauermann: Writing – review & editing, Investigation. Arash Mokhtari: Writing – review & editing, Investigation. Johan Nilsson: Writing – review & editing, Investigation. Jonas Persson: Writing – review & editing, Investigation. Per Stalby: Writing – review & editing, Investigation. Abu K.M.M. Islam: Writing – review & editing, Investigation. Afzalur Rahman: Writing – review & editing, Investigation. Fazila Malik: Writing – review & editing, Investigation. Sohel Choudhury: Writing – review & editing, Investigation. Timothy Collier: Data Curation, Formal analysis, Writing – review & editing. Stuart J. Pocock: Formal analysis, Writing – review & editing. John Pernow: Validation, Supervision, Writing – review & editing, Investigation.
Funding Information:
Funded by a grant from the Swedish Heart-Lung Foundation (project number 20150284), the Danish Heart Foundation (grant number 16-R107-A6596–22958), ALF Grants, and Nyckelfonden, Region Örebro, Sweden and by an unrestricted grant from Sanofi Pasteur, Lyon, France, who also provided the study vaccine. The authors are solely responsible for the design and implementation of this study, all study analyses, the drafting and editing of the paper, and its final content.
Publisher Copyright:
© 2022 Elsevier Inc.
ID: 396938986