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The association of influenza infection and vaccine with myocardial infarction: systematic review and meta-analysis of self-controlled case series.
Expert Review of Vaccines ( IF 5.5 ) Pub Date : 2019-12-10 , DOI: 10.1080/14760584.2019.1690459
Daniel Caldeira 1, 2, 3 , Bárbara Rodrigues 2 , Cláudio David 1, 2, 3 , João Costa 2, 3 , Fausto J Pinto 1 , Joaquim J Ferreira 2, 3
Affiliation  

Introduction: Influenza vaccination may be beneficial in coronary disease patients; however the infection and vaccination are associated with acute inflammation, a trigger of cardiovascular events. We aimed to review the risk of myocardial infarction (MI) associated with Influenza infection and the safety of vaccination in self-controlled case series (SCCS).Methods: We performed a systematic review with meta-analysis of SCCS studies to evaluate the risk of MI associated with Influenza infection/vaccination. Database search was performed in August/2018. The data were reported using the incident rate ratio (IRR) and 95% confidence interval (95%CI).Results: three studies for Influenza infection and two studies for Influenza vaccination were eligible. The risk of MI following an Influenza infection was significantly increased in the first 3 days (IRR 5.79; 95%CI: 3.59-9.38) and between 4-7 days (IRR 4.52; 95%CI: 2.80-7.32). In the first 4 weeks following the Influenza vaccination, there was a significant decrease of MI risk (IRR 0.84, 95%CI: 0.78-0.91).Conclusions: Short-term MI risk in Influenza infection is significantly increased, with a low-to-moderate confidence in the pooled evidence. The Influenza vaccine was safe regarding the short-term risk for MI, and the risk reduction is possibly related to a healthy period bias.

中文翻译:

流感感染和疫苗与心肌梗死的关联:系统分析和自我控制病例系列的荟萃分析。

简介:流感疫苗接种可能对冠心病患者有益;然而,感染和疫苗接种与急性发炎有关,这是心血管事件的触发因素。我们的目的是回顾自控病例系列(SCCS)中与流感感染相关的心肌梗塞(MI)的风险和疫苗接种的安全性。方法:我们对SCCS研究的荟萃分析进行了系统评价,以评估SCCS研究的风险。与流感感染/疫苗相关的心梗。数据库搜索于2018年8月进行。使用事件发生率比率(IRR)和95%置信区间(95%CI)报告数据。结果:符合三项针对流感感染的研究和两项针对流感疫苗接种的研究符合条件。流感感染后发生MI的风险在前3天(IRR 5.79; 95%CI:3.59-9.38)和4-7天之间(IRR 4.52; 95%CI:2.80-7.32)显着增加。流感疫苗接种后的前4周,MI风险显着降低(IRR 0.84,95%CI:0.78-0.91)。结论:流感感染的短期MI风险显着增加,低至-对汇总证据的信心中等。就MI的短期风险而言,流感疫苗是安全的,并且降低风险可能与健康期偏倚有关。流感感染的短期MI风险显着增加,对汇总证据的信心从低到中等。就MI的短期风险而言,流感疫苗是安全的,并且降低风险可能与健康期偏倚有关。流感感染的短期MI风险显着增加,对汇总证据的信心从低到中等。就MI的短期风险而言,流感疫苗是安全的,并且降低风险可能与健康期偏倚有关。
更新日期:2019-11-01
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