Comparative effectiveness of influenza vaccination dosing strategies for cardiovascular protection: A systematic review and network meta-analysis of randomized controlled trials
Pooled result · Trial-reported composite cardiovascular endpointResult — go to the resultRelative risk 0.74 95% CI 0.61–0.90Authors' conclusion
Influenza vaccination was associated with lower risks of cardiovascular events, all-cause death, cardiovascular death, and myocardial infarction in patients with cardiovascular disease, with mortality benefits concentrated in trials enrolling patients during acute cardiovascular admission. Higher-dose formulations did not demonstrate incremental cardiovascular benefit over standard-dose vaccination, although a directional advantage for HD-IIV against heart failure hospitalization was observed in a single trial and requires confirmation.
Study context
- Population
- Adults with established cardiovascular disease
- Participants
- 131,908 adults · 10 trials
- Comparison
- SD-IIV vs no vaccination
- Outcome
- trial-reported composite cardiovascular endpoint
Methodological detailspairwise meta-analysis, random-effects models
- Pairwise meta-analysis
- Random-effects models
Pooled result
Trial-reported composite cardiovascular endpoint
Relative risk
0.74
95% CI 0.61–0.90
As reported in the abstract
Further pooled results
| Outcome | RR (95% CI) | |
|---|---|---|
| All-cause death · pairwise analysis | 0.75 (0.64–0.89) | |
| Cardiovascular death · pairwise analysis | 0.63 (0.42–0.93) | |
| Myocardial infarction · pairwise analysis | 0.76 (0.62–0.94) | |
| Stroke · no significant reduction | 1.06 (0.72–1.54) | |
| Heart failure hospitalization · no significant reduction | 0.96 (0.60–1.54) | |
| 0.512Relative risk (log scale) |
Network meta-analysis rankings
- SD-IIV ranked highest across mortality and composite endpoints
- HD-IIV ranked highest for heart failure hospitalization and stroke
- No head-to-head dose comparison reached statistical significance
Original publication
Summarised from the published abstract; every number is checked against it