Cardio-oncology & otherMeta-analysis
Comparative effectiveness of influenza vaccination dosing strategies for cardiovascular protection: A systematic review and network meta-analysis of randomized controlled trials
- systematic review and network meta-analysis of randomized controlled trials
- pairwise meta-analysis
- random-effects models
Authors' 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 Ten trials
- Comparison
- SD-IIV vs no vaccination
- Outcome
- trial-reported composite cardiovascular endpoint
Pooled result
As reported in the abstract
Relative risk
0.74
95% CI 0.61–0.90
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