Influenza Vaccination and Cardiovascular Events in Japanese Patients With Heart Failure - Findings From the PARALLEL-HF Trial.

Circulation reports Pub Date : 2024-08-29 eCollection Date: 2024-09-10 DOI:10.1253/circrep.CR-24-0084
Hiroyuki Tsutsui, Shin-Ichi Momomura, Yoshihiko Saito, Hiroshi Ito, Kazuhiro Yamamoto, Yasushi Sakata, Tomomi Ohishi, Chiyo Ito
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Abstract

Background: Influenza is associated with an increased risk for cardiovascular events in patients with heart failure (HF). This study aimed to investigate the prevalence of influenza vaccination among Japanese patients with HF enrolled in the PARALLEL-HF (Prospective comparison of ARNI with ACEi to determine the noveL beneficiaL trEatment vaLue in Japanese Heart Failure patients) trial and the association between receiving influenza vaccination and cardiovascular events including death or HF hospitalization.

Methods and results: In PARALLEL-HF, in which 223 patients with HF and reduced ejection fraction (HFrEF) were randomized to the angiotensin-receptor neprilysin inhibitor (sacubitril/valsartan) or enalapril, 97 (43%) received influenza vaccination. Influenza vaccination tended to be associated, though statistically not significant, with a lower risk for all-cause death (adjusted hazard ratio [HR]: 0.67; 95% confidence interval [CI]: 0.32-1.39) and cardiopulmonary or influenza-related hospitalization or death (adjusted HR: 0.72; 95% CI: 0.46-1.11) in propensity score-adjusted models.

Conclusions: The influenza vaccination rate in Japanese patients with HFrEF who were well managed on guideline-directed medical therapy was suboptimal despite recommendations from clinical practice guidelines. However, importantly, it could be associated with better clinical benefits.

日本心力衰竭患者接种流感疫苗与心血管事件--PARALLEL-HF 试验的结果。
背景:流感与心力衰竭(HF)患者发生心血管事件的风险增加有关。本研究旨在调查参加 PARALLEL-HF(前瞻性比较 ARNI 与 ACEi 以确定日本心衰患者的新获益治疗价值)试验的日本心衰患者接种流感疫苗的普及率,以及接种流感疫苗与心血管事件(包括死亡或心衰住院)之间的关联:在 PARALLEL-HF 试验中,223 名射血分数降低的高血压患者被随机分配到血管紧张素受体肾素抑制剂(沙库比特利/缬沙坦)或依那普利治疗方案中,97 人(43%)接受了流感疫苗接种。在倾向评分调整模型中,流感疫苗接种往往与较低的全因死亡风险(调整后危险比 [HR]:0.67;95% 置信区间 [CI]:0.32-1.39)和心肺或流感相关住院或死亡风险(调整后危险比:0.72;95% 置信区间:0.46-1.11)相关,但统计学意义不大:结论:尽管有临床实践指南的建议,但在接受指南指导的药物治疗且病情控制良好的日本高频低氧血症患者中,流感疫苗接种率并不理想。然而,重要的是,接种流感疫苗能带来更好的临床疗效。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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