Flu Shot Cuts Risk for Death by Half in Heart Failure

Megan Brooks

March 09, 2018

ORLANDO — In patients with heart failure, getting the flu vaccine reduces the risk for dying of any cause during flu season and during the rest of the year, as well as the risk for being hospitalized for cardiovascular problems, a large review suggests.

"Our meta-analysis supports wider use of influenza vaccine in heart failure patients," Hidekatsu Fukuta, Nagoya City University Graduate School of Medical Sciences, Japan, told theheart.org | Medscape Cardiology.

Fukuta will present the study results March 11 at the American College of Cardiology (ACC) 2018 Scientific Session.

"Although there are no published randomized controlled trials examining the effect of influenza vaccination on clinical outcomes in heart failure patients, the effect has been examined in observational cohort studies," said Fukuta. "Nevertheless, results are inconsistent due partly to limited power with small sample sizes."

A large-scale randomized trial should be planned, they conclude, "to confirm our observed potential survival benefit from influenza vaccination in these patients."

The researchers analyzed data from five relevant observational cohort studies including 78,882 older patients with heart failure. The patients were aged 64 to 75 years on average, and follow-up lasted from 1 to 4 years.

Influenza vaccination reduced the risk for dying of any cause by 48% during flu season and 21% during the rest of the year. Vaccination also cut the risk for being hospitalized for cardiovascular problems by 22%.

Table. Mortality and Hospitalization Risk with Flu Vaccination

Endpoint Adjusted Risk (95% CI)
All-cause mortality during flu season 0.52 (0.39 - 0.69)
All-cause mortality outside flu season 0.79 (0.69 - 0.90)
Cardiovascular hospitalization during flu season 0.78 (0.68 - 0.89)


"To our knowledge, the present study is the first meta-analysis of the effect of influenza vaccination on mortality in heart failure patients," Fukuta said.  

It's noteworthy, he said, that the rate of influenza vaccination among the included studies varied widely, ranging from 26% to 86%, which "may be due to limited guideline recommendations for influenza vaccination in heart failure patients."

The Heart Failure Society of America recommends annual influenza vaccination for all patients with heart failure in the absence of known contraindications. The American College of Cardiology/American Heart Association (ACC/AHA) recommend annual influenza vaccination for patients with cardiovascular disease but do not make such specific recommendations in heart failure patients.

"This is a very impactful meta-analysis in heart failure patients," Robert Rosenson, MD, Mount Sinai Icahn School of Medicine, New York City, who was not involved in the research, told theheart.org | Medscape Cardiology.

"Clearly now with the major flu epidemic, the importance of annual flu vaccine and prompt treatment with an oral rescue agent is important to decrease morbidity and mortality in congestive heart failure patients," said Rosenson.

The study had no specific funding. Fukuta and Rosenson have no relevant disclosures.

American College of Cardiology (ACC) 2018 Annual Scientific Session. To be presented March 11, 2018.

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