Tags

Type your tag names separated by a space and hit enter

Influenza Vaccination is Associated with Lower Risk of Acute Coronary Syndrome in Elderly Patients with Chronic Kidney Disease.

Abstract

Elderly patients with chronic kidney disease (CKD) are at a higher risk of hospitalization for cardiovascular diseases (CVD). Previous studies have showed that influenza vaccination could reduce the risk of recurrent major cardiovascular events in patients with CVD. However, the effects of influenza vaccination on the reduction of first hospitalizations for acute coronary syndrome (ACS) in elderly patients with CKD remain unknown.We conducted a cohort study using data from the Taiwan Longitudinal Health Insurance Database 1997 to 2008. This cohort study comprised elderly patients (ages ≥55 years) with a recorded diagnosis of CKD (n = 4406) between January 1, 1999, and December 31, 2007. Each patient was followed up until the end of 2008. To minimize the selection bias of vaccine therapy, a propensity score adjustment was applied. The hazard ratio (HR) and 95% confidence interval (CI) for the association between the influenza vaccination and the occurrence of first hospitalization for ACS was evaluated by Cox proportional hazards regression. We further categorized the patients into 4 groups according to their vaccination status (unvaccinated, and total number of vaccinations: 1, 2-3, and ≥4).We found that elderly CKD patients without prior CVD history receiving influenza vaccination exhibited a lower risk of hospitalization for ACS (adjusted HR = 0.35, 95% CI 0.30-0.42; P < 0.001). We observed consistent protective effects regardless of age groups (55-64, 65-74, and ≥75), gender, and seasonality of influenza. When the patients were stratified according to the total number of vaccinations, the adjusted HRs for first ACS hospitalization were 0.62 (95% CI 0.52-0.81), 0.35 (95% CI 0.28-0.45), and 0.13 (95% CI 0.09-0.19) for patients who received 1, 2 to 3, and ≥4 vaccinations. There was a significant trend of decreasing risk of ACS hospitalization with an increasing number of vaccinations.The results of our observational study could strengthen the annual vaccination policy and physicians should be aware of missed opportunities to vaccinate elderly patients with CKD against influenza. The potential public health impact of influenza vaccination, particularly in the elderly CKD patients without a history of CVD, who are at risk for ACS, should be further explored.

Links

  • PMC Free PDF
  • PMC Free Full Text
  • FREE Publisher Full Text
  • Authors+Show Affiliations

    ,

    From the Taipei Cancer Center (C-IC, Y-AF), Cancer Center, Wan Fang Hospital (C-IC, Y-AF), Department of Healthcare Administration (C-IC), Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital (P-FK, J-CL, L-CS), Division of Nephrology, Department of Internal Medicine, Shuang Ho Hospital (MYW), College of Medical Science and Technology (JSM), and Department of Internal Medicine, School of Medicine, College of Medicine (P-FK, JCL), Taipei Medical University, Taipei, Taiwan; City of Hope National Medical Center, Duarte, CA (JSM).

    , , , , ,

    Source

    Medicine 95:5 2016 Feb pg e2588

    MeSH

    Acute Coronary Syndrome
    Aged
    Cohort Studies
    Female
    Humans
    Influenza Vaccines
    Male
    Middle Aged
    Renal Insufficiency, Chronic

    Pub Type(s)

    Journal Article
    Observational Study

    Language

    eng

    PubMed ID

    26844466

    Citation

    Chen, Chang-I, et al. "Influenza Vaccination Is Associated With Lower Risk of Acute Coronary Syndrome in Elderly Patients With Chronic Kidney Disease." Medicine, vol. 95, no. 5, 2016, pp. e2588.
    Chen CI, Kao PF, Wu MY, et al. Influenza Vaccination is Associated with Lower Risk of Acute Coronary Syndrome in Elderly Patients with Chronic Kidney Disease. Medicine (Baltimore). 2016;95(5):e2588.
    Chen, C. I., Kao, P. F., Wu, M. Y., Fang, Y. A., Miser, J. S., Liu, J. C., & Sung, L. C. (2016). Influenza Vaccination is Associated with Lower Risk of Acute Coronary Syndrome in Elderly Patients with Chronic Kidney Disease. Medicine, 95(5), pp. e2588. doi:10.1097/MD.0000000000002588.
    Chen CI, et al. Influenza Vaccination Is Associated With Lower Risk of Acute Coronary Syndrome in Elderly Patients With Chronic Kidney Disease. Medicine (Baltimore). 2016;95(5):e2588. PubMed PMID: 26844466.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Influenza Vaccination is Associated with Lower Risk of Acute Coronary Syndrome in Elderly Patients with Chronic Kidney Disease. AU - Chen,Chang-I, AU - Kao,Pai-Feng, AU - Wu,Mei-Yi, AU - Fang,Yu-Ann, AU - Miser,James S, AU - Liu,Ju-Chi, AU - Sung,Li-Chin, PY - 2016/2/5/entrez PY - 2016/2/6/pubmed PY - 2016/6/15/medline SP - e2588 EP - e2588 JF - Medicine JO - Medicine (Baltimore) VL - 95 IS - 5 N2 - Elderly patients with chronic kidney disease (CKD) are at a higher risk of hospitalization for cardiovascular diseases (CVD). Previous studies have showed that influenza vaccination could reduce the risk of recurrent major cardiovascular events in patients with CVD. However, the effects of influenza vaccination on the reduction of first hospitalizations for acute coronary syndrome (ACS) in elderly patients with CKD remain unknown.We conducted a cohort study using data from the Taiwan Longitudinal Health Insurance Database 1997 to 2008. This cohort study comprised elderly patients (ages ≥55 years) with a recorded diagnosis of CKD (n = 4406) between January 1, 1999, and December 31, 2007. Each patient was followed up until the end of 2008. To minimize the selection bias of vaccine therapy, a propensity score adjustment was applied. The hazard ratio (HR) and 95% confidence interval (CI) for the association between the influenza vaccination and the occurrence of first hospitalization for ACS was evaluated by Cox proportional hazards regression. We further categorized the patients into 4 groups according to their vaccination status (unvaccinated, and total number of vaccinations: 1, 2-3, and ≥4).We found that elderly CKD patients without prior CVD history receiving influenza vaccination exhibited a lower risk of hospitalization for ACS (adjusted HR = 0.35, 95% CI 0.30-0.42; P < 0.001). We observed consistent protective effects regardless of age groups (55-64, 65-74, and ≥75), gender, and seasonality of influenza. When the patients were stratified according to the total number of vaccinations, the adjusted HRs for first ACS hospitalization were 0.62 (95% CI 0.52-0.81), 0.35 (95% CI 0.28-0.45), and 0.13 (95% CI 0.09-0.19) for patients who received 1, 2 to 3, and ≥4 vaccinations. There was a significant trend of decreasing risk of ACS hospitalization with an increasing number of vaccinations.The results of our observational study could strengthen the annual vaccination policy and physicians should be aware of missed opportunities to vaccinate elderly patients with CKD against influenza. The potential public health impact of influenza vaccination, particularly in the elderly CKD patients without a history of CVD, who are at risk for ACS, should be further explored. SN - 1536-5964 UR - https://www.unboundmedicine.com/medline/citation/26844466/Influenza_Vaccination_is_Associated_with_Lower_Risk_of_Acute_Coronary_Syndrome_in_Elderly_Patients_with_Chronic_Kidney_Disease_ L2 - http://Insights.ovid.com/pubmed?pmid=26844466 DB - PRIME DP - Unbound Medicine ER -