Influenza vaccination and cardiovascular risk in patients with recent TIA and stroke.
- Lavallée PC From INSERM U 698 and Paris-Diderot University (P.C.L., J.L., P.G.S., P.A.), Sorbonne Paris Cité; Department of Neurology and Stroke Centre (P.C.L., J.L., P.A.) and Department of Cardiology (P.G.S.), AP-HP, Bichat University Hospital, Paris, France; NHLI Imperial College (K.M.F.), ICMS, Royal Brompton Hospital, London, UK; Unidad de Tratamiento de Ataque Cerebrovascular (P.L.), Clínica Alemana de Santiago Universidad del Desarrollo, Santiago, Chile; Neurologische Klinik und Poliklinik (H.M.), Universität Bern, Inselspital, Switzerland.
- Labreuche J From INSERM U 698 and Paris-Diderot University (P.C.L., J.L., P.G.S., P.A.), Sorbonne Paris Cité; Department of Neurology and Stroke Centre (P.C.L., J.L., P.A.) and Department of Cardiology (P.G.S.), AP-HP, Bichat University Hospital, Paris, France; NHLI Imperial College (K.M.F.), ICMS, Royal Brompton Hospital, London, UK; Unidad de Tratamiento de Ataque Cerebrovascular (P.L.), Clínica Alemana de Santiago Universidad del Desarrollo, Santiago, Chile; Neurologische Klinik und Poliklinik (H.M.), Universität Bern, Inselspital, Switzerland.
- Fox KM From INSERM U 698 and Paris-Diderot University (P.C.L., J.L., P.G.S., P.A.), Sorbonne Paris Cité; Department of Neurology and Stroke Centre (P.C.L., J.L., P.A.) and Department of Cardiology (P.G.S.), AP-HP, Bichat University Hospital, Paris, France; NHLI Imperial College (K.M.F.), ICMS, Royal Brompton Hospital, London, UK; Unidad de Tratamiento de Ataque Cerebrovascular (P.L.), Clínica Alemana de Santiago Universidad del Desarrollo, Santiago, Chile; Neurologische Klinik und Poliklinik (H.M.), Universität Bern, Inselspital, Switzerland.
- Lavados P From INSERM U 698 and Paris-Diderot University (P.C.L., J.L., P.G.S., P.A.), Sorbonne Paris Cité; Department of Neurology and Stroke Centre (P.C.L., J.L., P.A.) and Department of Cardiology (P.G.S.), AP-HP, Bichat University Hospital, Paris, France; NHLI Imperial College (K.M.F.), ICMS, Royal Brompton Hospital, London, UK; Unidad de Tratamiento de Ataque Cerebrovascular (P.L.), Clínica Alemana de Santiago Universidad del Desarrollo, Santiago, Chile; Neurologische Klinik und Poliklinik (H.M.), Universität Bern, Inselspital, Switzerland.
- Mattle H From INSERM U 698 and Paris-Diderot University (P.C.L., J.L., P.G.S., P.A.), Sorbonne Paris Cité; Department of Neurology and Stroke Centre (P.C.L., J.L., P.A.) and Department of Cardiology (P.G.S.), AP-HP, Bichat University Hospital, Paris, France; NHLI Imperial College (K.M.F.), ICMS, Royal Brompton Hospital, London, UK; Unidad de Tratamiento de Ataque Cerebrovascular (P.L.), Clínica Alemana de Santiago Universidad del Desarrollo, Santiago, Chile; Neurologische Klinik und Poliklinik (H.M.), Universität Bern, Inselspital, Switzerland.
- Steg PG From INSERM U 698 and Paris-Diderot University (P.C.L., J.L., P.G.S., P.A.), Sorbonne Paris Cité; Department of Neurology and Stroke Centre (P.C.L., J.L., P.A.) and Department of Cardiology (P.G.S.), AP-HP, Bichat University Hospital, Paris, France; NHLI Imperial College (K.M.F.), ICMS, Royal Brompton Hospital, London, UK; Unidad de Tratamiento de Ataque Cerebrovascular (P.L.), Clínica Alemana de Santiago Universidad del Desarrollo, Santiago, Chile; Neurologische Klinik und Poliklinik (H.M.), Universität Bern, Inselspital, Switzerland.
- Amarenco P From INSERM U 698 and Paris-Diderot University (P.C.L., J.L., P.G.S., P.A.), Sorbonne Paris Cité; Department of Neurology and Stroke Centre (P.C.L., J.L., P.A.) and Department of Cardiology (P.G.S.), AP-HP, Bichat University Hospital, Paris, France; NHLI Imperial College (K.M.F.), ICMS, Royal Brompton Hospital, London, UK; Unidad de Tratamiento de Ataque Cerebrovascular (P.L.), Clínica Alemana de Santiago Universidad del Desarrollo, Santiago, Chile; Neurologische Klinik und Poliklinik (H.M.), Universität Bern, Inselspital, Switzerland. pierre.amarenco@bch.aphp.fr.
- 2014-05-03
Published in:
- Neurology. - 2014
Aged
Cardiovascular Diseases
Cohort Studies
Female
Humans
Influenza Vaccines
Ischemic Attack, Transient
Male
Middle Aged
Myocardial Infarction
Prospective Studies
Randomized Controlled Trials as Topic
Risk Factors
Stroke
Vaccination
English
OBJECTIVES
To determine whether current influenza vaccination is associated with reduced risk of major vascular events in patients with recent ischemic stroke or TIA of mainly atherothrombotic origin.
METHODS
Data were pooled from 2 prospective cohort studies, the OPTIC Registry (n = 3,635) and the AMISTAD Study (n = 618), and from the randomized PERFORM Trial (n = 19,120), all of which included patients with recent ischemic stroke or TIA. Influenza vaccination status was determined in 23,110 patients. The primary outcome was a composite of nonfatal myocardial infarction, nonfatal stroke, or vascular death up to 2 years. Secondary outcomes were myocardial infarction and stroke separately.
RESULTS
Influenza vaccination had no association with the primary outcome in the propensity score-matched cohort (hazard ratio 0.97, 95% confidence interval [CI] 0.85-1.11; p = 0.67) or in the propensity score-adjusted cohort (hazard ratio 1.00, 95% CI 0.89-1.12; p = 0.99). Similarly, the risk of stroke and myocardial infarction did not differ between the vaccinated group and the unvaccinated group; in the matched cohort, the hazard ratio was 1.01 (95% CI 0.88-1.17; p = 0.89) for stroke and 0.84 (95% CI 0.59-1.18; p = 0.30) for myocardial infarction.
CONCLUSIONS
Influenza vaccination was not associated with reduced outcome events in patients with recent atherothrombotic ischemic stroke after considering all baseline characteristics (including concomitant medications) associated with influenza vaccination.
To determine whether current influenza vaccination is associated with reduced risk of major vascular events in patients with recent ischemic stroke or TIA of mainly atherothrombotic origin.
METHODS
Data were pooled from 2 prospective cohort studies, the OPTIC Registry (n = 3,635) and the AMISTAD Study (n = 618), and from the randomized PERFORM Trial (n = 19,120), all of which included patients with recent ischemic stroke or TIA. Influenza vaccination status was determined in 23,110 patients. The primary outcome was a composite of nonfatal myocardial infarction, nonfatal stroke, or vascular death up to 2 years. Secondary outcomes were myocardial infarction and stroke separately.
RESULTS
Influenza vaccination had no association with the primary outcome in the propensity score-matched cohort (hazard ratio 0.97, 95% confidence interval [CI] 0.85-1.11; p = 0.67) or in the propensity score-adjusted cohort (hazard ratio 1.00, 95% CI 0.89-1.12; p = 0.99). Similarly, the risk of stroke and myocardial infarction did not differ between the vaccinated group and the unvaccinated group; in the matched cohort, the hazard ratio was 1.01 (95% CI 0.88-1.17; p = 0.89) for stroke and 0.84 (95% CI 0.59-1.18; p = 0.30) for myocardial infarction.
CONCLUSIONS
Influenza vaccination was not associated with reduced outcome events in patients with recent atherothrombotic ischemic stroke after considering all baseline characteristics (including concomitant medications) associated with influenza vaccination.
- Language
-
- English
- Open access status
- green
- Identifiers
-
- DOI 10.1212/WNL.0000000000000456
- PMID 24789867
- Persistent URL
- https://sonar.ch/global/documents/172821
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