Jan Biegus, Leszek Szenborn, Michał Tkaczyszyn, Robert Zymlinski, Gad Cotter, Michał Zakliczynski, Krzysztof Reczuch, Mateusz Guzik, Szymon Urban, Marta Rosiek-Biegus, Berenika Jankowiak, Gracjan Iwanek, Marta Wleklik, Marat Fudim, Piotr Ponikowski
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The primary composite endpoint comprised all-cause death, HF hospitalization (HFH) or clinical signs/symptoms of infection within a 6 month follow-up period (regular structured telephone interview). Secondary endpoints were components of the composite primary endpoint.</p><p><strong>Results: </strong>Two hundred twenty patients were randomized. During the follow-up period, the primary endpoint occurred in 59% of patients in the vaccination group versus 75% in the SOC group [hazard ratio (HR) 0.66, 95% confidence interval (CI) 0.48-0.92, P = 0.01]. Regarding the secondary endpoint analyses, during 6 month follow-up, 3% in the vaccination group died compared with 5% of patients in the SOC arm (HR 0.50, 95% CI 0.12 1.99, P = 0.32), and 18% versus 16% of study participants were hospitalized for HF in the two study arms, respectively (HR 0.86, 95% CI 0.45-1.62, P = 0.64). Infection occurred in 53% of vaccinated patients compared with 68% in SOC (HR 0.68, 95% CI 0.48-0.96, P = 0.03).</p><p><strong>Conclusions: </strong>In the population of high-risk HF, simultaneous vaccination against influenza and RSV reduced the incidence of the primary outcome. 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The primary composite endpoint comprised all-cause death, HF hospitalization (HFH) or clinical signs/symptoms of infection within a 6 month follow-up period (regular structured telephone interview). Secondary endpoints were components of the composite primary endpoint.</p><p><strong>Results: </strong>Two hundred twenty patients were randomized. During the follow-up period, the primary endpoint occurred in 59% of patients in the vaccination group versus 75% in the SOC group [hazard ratio (HR) 0.66, 95% confidence interval (CI) 0.48-0.92, P = 0.01]. Regarding the secondary endpoint analyses, during 6 month follow-up, 3% in the vaccination group died compared with 5% of patients in the SOC arm (HR 0.50, 95% CI 0.12 1.99, P = 0.32), and 18% versus 16% of study participants were hospitalized for HF in the two study arms, respectively (HR 0.86, 95% CI 0.45-1.62, P = 0.64). 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引用次数: 0
摘要
背景:目前缺乏关于呼吸道病毒疫苗接种对心力衰竭(HF)患者硬临床终点影响的前瞻性数据。目的:我们调查在高危HF患者人群中,同时接种流感和呼吸道合胞病毒(RSV)疫苗是否能改善随后感染季节的预后。方法:我们进行了一项前瞻性、随机、单中心、开放标签的研究,在该研究中,高危HF患者以1:1的比例随机分组,同时接种流感和RSV疫苗或接受标准治疗(SOC)。主要复合终点包括6个月随访期内的全因死亡、心衰住院(HFH)或感染的临床体征/症状(定期结构化电话访谈)。次要终点是复合主要终点的组成部分。结果:随机选取220例患者。在随访期间,接种组59%的患者出现主要终点,而SOC组为75%[风险比(HR) 0.66, 95%可信区间(CI) 0.48-0.92, P = 0.01]。关于次要终点分析,在6个月的随访期间,接种组中有3%的患者死亡,而SOC组中有5%的患者死亡(HR 0.50, 95% CI 0.12 1.99, P = 0.32),两个研究组中分别有18%和16%的研究参与者因HF住院(HR 0.86, 95% CI 0.45-1.62, P = 0.64)。接种疫苗的患者感染发生率为53%,而SOC组为68% (HR 0.68, 95% CI 0.48-0.96, P = 0.03)。结论:在高危HF人群中,同时接种流感和RSV疫苗可降低主要结局的发生率。这种效果是由感染的显著减少所驱动的。
Simultaneous vaccination against influenza and respiratory syncytial virus in high-risk heart failure patients.
Background: There is a scarcity of prospective data on the impact of available vaccinations against respiratory viruses on hard clinical endpoints in patients with heart failure (HF).
Aims: We investigated whether, in the population of high-risk HF patients, simultaneous vaccination against influenza and respiratory syncytial virus (RSV) improves outcomes during the subsequent infection season.
Methods: We conducted a prospective, randomized, single-centre, open-label study in which patients with high-risk HF were randomized 1:1 to simultaneous influenza and RSV vaccination or standard of care (SOC). The primary composite endpoint comprised all-cause death, HF hospitalization (HFH) or clinical signs/symptoms of infection within a 6 month follow-up period (regular structured telephone interview). Secondary endpoints were components of the composite primary endpoint.
Results: Two hundred twenty patients were randomized. During the follow-up period, the primary endpoint occurred in 59% of patients in the vaccination group versus 75% in the SOC group [hazard ratio (HR) 0.66, 95% confidence interval (CI) 0.48-0.92, P = 0.01]. Regarding the secondary endpoint analyses, during 6 month follow-up, 3% in the vaccination group died compared with 5% of patients in the SOC arm (HR 0.50, 95% CI 0.12 1.99, P = 0.32), and 18% versus 16% of study participants were hospitalized for HF in the two study arms, respectively (HR 0.86, 95% CI 0.45-1.62, P = 0.64). Infection occurred in 53% of vaccinated patients compared with 68% in SOC (HR 0.68, 95% CI 0.48-0.96, P = 0.03).
Conclusions: In the population of high-risk HF, simultaneous vaccination against influenza and RSV reduced the incidence of the primary outcome. The effect was driven by a significant reduction in infections.
期刊介绍:
ESC Heart Failure is the open access journal of the Heart Failure Association of the European Society of Cardiology dedicated to the advancement of knowledge in the field of heart failure. The journal aims to improve the understanding, prevention, investigation and treatment of heart failure. Molecular and cellular biology, pathology, physiology, electrophysiology, pharmacology, as well as the clinical, social and population sciences all form part of the discipline that is heart failure. Accordingly, submission of manuscripts on basic, translational, clinical and population sciences is invited. Original contributions on nursing, care of the elderly, primary care, health economics and other specialist fields related to heart failure are also welcome, as are case reports that highlight interesting aspects of heart failure care and treatment.