Flu, pneumonia vaccines may improve health of heart failure patients

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Flu and pneumonia vaccines may improve the quality of life and outcomes of heart failure patients by providing cost-effective protection against life-threatening respiratory infections, according to a review paper published today in JACC: Heart Failure.

In a 2005 report, the Centers for Disease Control and Prevention recommended yearly flu vaccinations for adults with chronic cardiovascular disease, including heart failure. Recommendations for a yearly flu vaccination are supported by cardiology societies, including the American College of Cardiology (ACC), which states in its guidelines that patients with cardiovascular disease should have an annual flu vaccine. ACC also recommends pneumonia vaccines for secondary prevention of heart failure.

However, the impact of vaccination in heart failure patients is incompletely studied, since most vaccination trials either have not enrolled heart failure patients or not assessed the impact of vaccines in a heart failure cohort sub-study.

“A deeper understanding of current vaccination practices within the heart failure population is necessary to guide population-level interventions aimed at improving vaccination rates,” says Robert J Mentz, senior author of the review paper and an assistant professor of medicine at Duke University (Durham, USA). “Vaccination represents a low-cost intervention that may be able to prevent the significant disease, death and cost associated with heart failure.”

Authors of the review paper looked at relevant published studies from January 1990 to July 2016 on interventions involving the use of pneumonia or flu vaccines in heart failure patients or related to heart failure outcomes.

They found that preliminary evidence across prior studies suggests flu and pneumonia vaccines have a protective effect in heart failure patients, but data are still limited. Recent evidence also shows a benefit in giving heart failure patients over the age of 65 a high-dose vaccination since many patients with heart failure may have a decreased immune response to a standard dose. However, questions still remain.

“The ongoing trial entitled ‘INfluenza Vaccine to Effectively Stop Cardio Thoracic Events and Decompensated Heart Failure (INVESTED)’…is testing whether high dose trivalent influenza vaccine will reduce cardiopulmonary events to a greater extent than standard dose quadrivalent influenza vaccine in high-risk cardiovascular patients with a recent history of myocardial infarction or heart failure,” said JACC: Heart Failure editor-in-chief Christopher O’Connor. “This continued research is critical in ensuring we are protecting vulnerable heart failure patients from preventable complications like flu and pneumonia.”

 

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