Influenza Vaccination after Myocardial Infarction: A Randomized, Double-Blind, Placebo-Controlled, Multicenter Trial

Ole Frøbert, Matthias Götberg, David Erlinge, Zubair Akhtar, Evald H. Christiansen, Chandini R. MacIntyre, Keith G. Oldroyd, Zuzana Motovska, Andrejs Erglis, Rasmus Moer, Ota Hlinomaz, Lars Jakobsen, Thomas Engstrøm, Lisette O. Jensen, Christian O. Fallesen, Svend E. Jensen, Oskar Angerås, Fredrik Calais, Amra Kåregren, Jörg Lauermann, Arash Mokhtari, Johan Nilsson, Jonas Persson, Per Stalby, Abu K.M.M. Islam, Afzalur Rahman, Fazila Malik, Sohel Choudhury, Timothy Collier, Stuart J. Pocock, and John Pernow

Article available online here: ahajournals.org

Background:

Observational and small randomized studies suggest that influenza vaccine may reduce future cardiovascular events in patients with cardiovascular disease.

Methods:

We conducted an investigator-initiated, randomized, double-blind trial to compare inactivated influenza vaccine with saline placebo administered shortly after myocardial infarction (MI) (99.7% of patients) or high-risk stable coronary heart disease (0.3%). The primary endpoint was the composite of all-cause death, MI, or stent thrombosis at 12 months. A hierarchical testing strategy was used for the key secondary endpoints: all-cause death, cardiovascular death, MI, and stent thrombosis.

Conclusions:

Influenza vaccination early after an MI or in high-risk coronary heart disease resulted in a lower risk of a composite of all-cause death, MI, or stent thrombosis, as well as a lower risk of all-cause death and cardiovascular death at 12 months compared with placebo.

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First published: 1 September 2021