What is the clinical evidence from this study?

Study design: Meta-Analysis. Population: Arrhythmia (n=3169977). Intervention: Influenza vaccination vs. Unvaccinated or beyond efficacy period. Primary outcome: Risk of arrhythmia (OR 0.82, 95% CI 0.70-0.97, p=0.02).

October 20, 2022Open Access

Influenza vaccination is associated with a decreased risk of atrial fibrillation: A systematic review and meta-analysis

MLMenglu LiuJiangsu University WLWeichun LinSun Yat-sen University TSTiangang SongNanchang University

Key Result

Influenza vaccination was associated with an 18% decreased risk of arrhythmia compared to no vaccination (OR 0.82) based on a meta-analysis of observational studies.

Study Design

Type

Meta-Analysis (n=3,169,977)

Structured PICO

Does influenza vaccination reduce the risk of arrhythmia in adult patients?

Population

3,169,977 adults across 1 RCT and 6 observational studies evaluated for the association between influenza vaccination and the risk of incident arrhythmias.

Intervention

Influenza vaccination (defined as receiving vaccine in previous 12 months, during follow-up, or self-reported)

Comparator

Unvaccinated group

Outcome

Risk of arrhythmiacomposite

Influenza vaccination is associated with a significantly reduced risk of arrhythmias, particularly atrial fibrillation, supporting its broader use as a preventive measure in cardiovascular care.

Main Result

Odds Ratio: 0.82 (95% CI 0.7–0.97)

p-value: p=0.02

Limitations

Most included studies were observational, precluding causal inference.
Retrospective design of observational studies introduces potential recall bias.
Some studies did not adjust for key clinical confounders like age or comorbidities.
Substantial heterogeneity (I2=76%) was observed in the main results.
Highly heterogeneous participant populations with different baseline health conditions.

Abstract

Background Evidence from longitudinal studies has shown that influenza infection is linked to an increased risk of arrhythmia. Therefore, we aimed to assess the role of influenza vaccination in arrhythmia prevention. Materials and methods The PubMed, Embase, and Cochrane Library databases were searched to identify studies that investigated the potential effects of the influenza vaccine on arrhythmia risk published until October 25th, 2021. The study was registered with PROSPERO (CRD42022300815). Results One RCT with 2,532 patients and six observational studies with 3,167,445 patients were included. One RCT demonstrated a non-significant benefit of the influenza vaccine against arrhythmias odds ratio (OR) = 0.43, 95% confidence interval (CI): 0.11–1.64; P = 0.20 in patients after myocardial infarction or those with high-risk stable coronary heart disease. A meta-analysis based on observational studies showed that vaccination was associated with a significantly lower risk of arrhythmia (OR: 0.82, 95% CI: 0.70–0.97; P = 0.02; I 2 = 76%). Additionally, subgroup analysis showed a decreased risk of atrial fibrillation (AF) (OR: 0.94, 95% CI: 0.90–0.98; P = 0.006; I 2 = 0%) and a non-significant but positive trend concerning ventricular arrhythmias (VAs) (OR: 0.68, 95% CI: 0.42–1.11; P = 0.12; I 2 = 85%) after influenza vaccination. Conclusion Based on the current evidence, influenza vaccination may be associated with a reduced risk of arrhythmia, especially AF. Influenza vaccination may be an effective tool for the prevention of arrhythmias. The effect of influenza vaccination on the risk of VAs and arrhythmias in patients at low risk for cardiovascular diseases should be further studied. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/ , identifier CRD42022300815.

Ask AI

Helpful

Bookmark

View Full Paper