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Influenza vaccination reduces hospitalization for acute coronary syndrome in elderly patients with chronic obstructive pulmonary disease: A population-based cohort study

•Elderly patients with chronic obstructive pulmonary disease (COPD) are at high risk of acute coronary syndrome.•Large population-based cohort study to investigate the protective effect of influenza vaccination against coronary events.•We evaluate elderly patients (≥55 years old) with COPD.•The prot... Full description

Journal Title: Vaccine 24 June 2014, Vol.32(30), pp.3843-3849
Main Author: Sung, Li-Chin
Other Authors: Chen, Chang-I , Fang, Yu-Ann , Lai, Chih-Hong , Hsu, Yi-Ping , Cheng, Tzu-Hurng , Miser, James S , Liu, Ju-Chi
Format: Electronic Article Electronic Article
Language: English
Subjects:
ID: ISSN: 0264-410X ; E-ISSN: 1873-2518 ; DOI: 10.1016/j.vaccine.2014.04.064
Link: https://www.sciencedirect.com/science/article/pii/S0264410X14006021
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recordid: elsevier_sdoi_10_1016_j_vaccine_2014_04_064
title: Influenza vaccination reduces hospitalization for acute coronary syndrome in elderly patients with chronic obstructive pulmonary disease: A population-based cohort study
format: Article
creator:
  • Sung, Li-Chin
  • Chen, Chang-I
  • Fang, Yu-Ann
  • Lai, Chih-Hong
  • Hsu, Yi-Ping
  • Cheng, Tzu-Hurng
  • Miser, James S
  • Liu, Ju-Chi
subjects:
  • Acute Coronary Syndromes
  • Influenza Vaccines
  • Pulmonary Disease
  • Chronic Obstructive
  • Cohort Studies
  • Medicine
  • Biology
  • Veterinary Medicine
  • Pharmacy, Therapeutics, & Pharmacology
ispartof: Vaccine, 24 June 2014, Vol.32(30), pp.3843-3849
description: •Elderly patients with chronic obstructive pulmonary disease (COPD) are at high risk of acute coronary syndrome.•Large population-based cohort study to investigate the protective effect of influenza vaccination against coronary events.•We evaluate elderly patients (≥55 years old) with COPD.•The protective effect exists and intensifies as the total number of annual vaccination increases.•We suggest annual influenza vaccination for this high-risk group of patients. BackgroundElderly patients with chronic obstructive pulmonary disease (COPD) are at a higher risk of hospitalization for cardiovascular complications, especially during respiratory infections. Previous studies showed that vaccination for influenza may reduce the risk of recurrent major cardiovascular events in patients with acute coronary syndrome (ACS). The purpose of this study was to evaluate the hypothesis that influenza vaccination could reduce hospitalizations for ACS in elderly patients with COPD. MethodUsing the Taiwan Longitudinal Health Insurance Database 1996–2008, this cohort study comprised elderly patients (≥55 years old) with a recorded diagnosis of COPD (n=7722) between January 1, 2000 and December 31, 2007. Each patient was followed until the end of 2007. A propensity score was derived by using a logistic regression model to reduce vaccine therapy selection bias. The hazard ratio (HR) and 95% confidence interval (CI) for the association between the influenza vaccination and the occurrence of first hospitalization for ACS in elderly COPD patients was examined by Cox proportional hazards regression analysis. In addition, we categorized the patients into four groups according to vaccination status (unvaccinated, total number of vaccinations: 1, 2−3, and ≥4). ResultsWe found that elderly patients with COPD receiving influenza vaccination had a lower risk of hospitalization for ACS (adjusted HR=0.46, 95% CI (0.39–0.55), p
language: eng
source:
identifier: ISSN: 0264-410X ; E-ISSN: 1873-2518 ; DOI: 10.1016/j.vaccine.2014.04.064
fulltext: fulltext
issn:
  • 0264-410X
  • 0264410X
  • 1873-2518
  • 18732518
url: Link


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titleInfluenza vaccination reduces hospitalization for acute coronary syndrome in elderly patients with chronic obstructive pulmonary disease: A population-based cohort study
creatorSung, Li-Chin ; Chen, Chang-I ; Fang, Yu-Ann ; Lai, Chih-Hong ; Hsu, Yi-Ping ; Cheng, Tzu-Hurng ; Miser, James S ; Liu, Ju-Chi
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subjectAcute Coronary Syndromes ; Influenza Vaccines ; Pulmonary Disease ; Chronic Obstructive ; Cohort Studies ; Medicine ; Biology ; Veterinary Medicine ; Pharmacy, Therapeutics, & Pharmacology
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description•Elderly patients with chronic obstructive pulmonary disease (COPD) are at high risk of acute coronary syndrome.•Large population-based cohort study to investigate the protective effect of influenza vaccination against coronary events.•We evaluate elderly patients (≥55 years old) with COPD.•The protective effect exists and intensifies as the total number of annual vaccination increases.•We suggest annual influenza vaccination for this high-risk group of patients. BackgroundElderly patients with chronic obstructive pulmonary disease (COPD) are at a higher risk of hospitalization for cardiovascular complications, especially during respiratory infections. Previous studies showed that vaccination for influenza may reduce the risk of recurrent major cardiovascular events in patients with acute coronary syndrome (ACS). The purpose of this study was to evaluate the hypothesis that influenza vaccination could reduce hospitalizations for ACS in elderly patients with COPD. MethodUsing the Taiwan Longitudinal Health Insurance Database 1996–2008, this cohort study comprised elderly patients (≥55 years old) with a recorded diagnosis of COPD (n=7722) between January 1, 2000 and December 31, 2007. Each patient was followed until the end of 2007. A propensity score was derived by using a logistic regression model to reduce vaccine therapy selection bias. The hazard ratio (HR) and 95% confidence interval (CI) for the association between the influenza vaccination and the occurrence of first hospitalization for ACS in elderly COPD patients was examined by Cox proportional hazards regression analysis. In addition, we categorized the patients into four groups according to vaccination status (unvaccinated, total number of vaccinations: 1, 2−3, and ≥4). ResultsWe found that elderly patients with COPD receiving influenza vaccination had a lower risk of hospitalization for ACS (adjusted HR=0.46, 95% CI (0.39–0.55), p<0.001). We observed similar protective effects in both sexes and all age groups (55−64, 65−74, ≥75) regardless of influenza seasonality. When the patients were stratified according to the total number of vaccinations, the adjusted HRs for hospitalization because of ACS were 0.48 (0.38−0.62) and 0.20 (0.14−0.28) for patients who received 2−3 and ≥4 vaccinations during the follow-up period. ConclusionOur data showed that there was a lower risk of ACS hospitalization in elderly patients with COPD receiving annual influenza vaccination.
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