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Influenza Vaccination and the Risk of Ventricular Arrhythmias in Patients With Chronic Obstructive Pulmonary Disease: A Population-Based Longitudinal Study

Backgrounds: Influenza vaccination could decrease the risk of major cardiac events in patients with chronic obstructive pulmonary disease (COPD). However, the effects of the vaccine on decreasing the risk of ventricular arrhythmia (VA) development in such patients remain unclear. Methods: We retrosp...

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Autores principales: Chen, Chun-Chao, Lin, Cheng-Hsin, Hao, Wen-Rui, Yeh, Jong-Shiuan, Chiang, Kuang-Hsing, Fang, Yu-Ann, Chiu, Chun-Chih, Yang, Tsung Yeh, Wu, Yu-Wei, Liu, Ju-Chi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8551488/
https://www.ncbi.nlm.nih.gov/pubmed/34722665
http://dx.doi.org/10.3389/fcvm.2021.731844
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author Chen, Chun-Chao
Lin, Cheng-Hsin
Hao, Wen-Rui
Yeh, Jong-Shiuan
Chiang, Kuang-Hsing
Fang, Yu-Ann
Chiu, Chun-Chih
Yang, Tsung Yeh
Wu, Yu-Wei
Liu, Ju-Chi
author_facet Chen, Chun-Chao
Lin, Cheng-Hsin
Hao, Wen-Rui
Yeh, Jong-Shiuan
Chiang, Kuang-Hsing
Fang, Yu-Ann
Chiu, Chun-Chih
Yang, Tsung Yeh
Wu, Yu-Wei
Liu, Ju-Chi
author_sort Chen, Chun-Chao
collection PubMed
description Backgrounds: Influenza vaccination could decrease the risk of major cardiac events in patients with chronic obstructive pulmonary disease (COPD). However, the effects of the vaccine on decreasing the risk of ventricular arrhythmia (VA) development in such patients remain unclear. Methods: We retrospectively analyzed the data of 18,658 patients with COPD (≥55 years old) from the National Health Insurance Research Database from January 1, 2001, to December 31, 2012. After a 1:1 propensity score matching by the year of diagnosis, we divided the patients into vaccinated and unvaccinated groups. Time-varying Cox proportional hazards regression was applied to assess the time to event hazards of influenza vaccination exposure. Results: The risk of VA occurrence was significantly lower in the vaccinated group during influenza season and all seasons [adjusted hazard ratio (aHR): 0.62, 95% CI: 0.41–0.95; aHR: 0.69, 95% CI: 0.44–1.08; and aHR: 0.65, 95% CI: 0.48–0.89, in the influenza season, non-influenza season, and all seasons, respectively]. Among patients with CHA(2)DS(2)-VASc scores (conditions and characteristics included congestive heart failure, hypertension, diabetes, stroke, vascular disease, age, and sex) of 2–3, receiving one time and two to three times of influenza vaccination were associated with lower risk of VA occurrence in all seasons (aHR: 0.28, 95% CI: 0.10–0.80; aHR: 0.27, 95% CI: 0.10–0.68, respectively). Among patients without stroke, peripheral vascular disease, and diabetes, a lower risk of VA occurrence after receiving one and two to three times vaccination was observed in all seasons. Among patients with a history of asthma and patients without a history of heart failure, ischemic heart disease, angina hypertension, or renal failure, a significantly lower risk of VA occurrence was observed after the first time of vaccination in all seasons. Conclusions: Influenza vaccination may be associated with lower risks of VA among patients with COPD aged 55–74. Further investigation is still needed to resolve this clinical question.
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spelling pubmed-85514882021-10-29 Influenza Vaccination and the Risk of Ventricular Arrhythmias in Patients With Chronic Obstructive Pulmonary Disease: A Population-Based Longitudinal Study Chen, Chun-Chao Lin, Cheng-Hsin Hao, Wen-Rui Yeh, Jong-Shiuan Chiang, Kuang-Hsing Fang, Yu-Ann Chiu, Chun-Chih Yang, Tsung Yeh Wu, Yu-Wei Liu, Ju-Chi Front Cardiovasc Med Cardiovascular Medicine Backgrounds: Influenza vaccination could decrease the risk of major cardiac events in patients with chronic obstructive pulmonary disease (COPD). However, the effects of the vaccine on decreasing the risk of ventricular arrhythmia (VA) development in such patients remain unclear. Methods: We retrospectively analyzed the data of 18,658 patients with COPD (≥55 years old) from the National Health Insurance Research Database from January 1, 2001, to December 31, 2012. After a 1:1 propensity score matching by the year of diagnosis, we divided the patients into vaccinated and unvaccinated groups. Time-varying Cox proportional hazards regression was applied to assess the time to event hazards of influenza vaccination exposure. Results: The risk of VA occurrence was significantly lower in the vaccinated group during influenza season and all seasons [adjusted hazard ratio (aHR): 0.62, 95% CI: 0.41–0.95; aHR: 0.69, 95% CI: 0.44–1.08; and aHR: 0.65, 95% CI: 0.48–0.89, in the influenza season, non-influenza season, and all seasons, respectively]. Among patients with CHA(2)DS(2)-VASc scores (conditions and characteristics included congestive heart failure, hypertension, diabetes, stroke, vascular disease, age, and sex) of 2–3, receiving one time and two to three times of influenza vaccination were associated with lower risk of VA occurrence in all seasons (aHR: 0.28, 95% CI: 0.10–0.80; aHR: 0.27, 95% CI: 0.10–0.68, respectively). Among patients without stroke, peripheral vascular disease, and diabetes, a lower risk of VA occurrence after receiving one and two to three times vaccination was observed in all seasons. Among patients with a history of asthma and patients without a history of heart failure, ischemic heart disease, angina hypertension, or renal failure, a significantly lower risk of VA occurrence was observed after the first time of vaccination in all seasons. Conclusions: Influenza vaccination may be associated with lower risks of VA among patients with COPD aged 55–74. Further investigation is still needed to resolve this clinical question. Frontiers Media S.A. 2021-10-14 /pmc/articles/PMC8551488/ /pubmed/34722665 http://dx.doi.org/10.3389/fcvm.2021.731844 Text en Copyright © 2021 Chen, Lin, Hao, Yeh, Chiang, Fang, Chiu, Yang, Wu and Liu. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Cardiovascular Medicine
Chen, Chun-Chao
Lin, Cheng-Hsin
Hao, Wen-Rui
Yeh, Jong-Shiuan
Chiang, Kuang-Hsing
Fang, Yu-Ann
Chiu, Chun-Chih
Yang, Tsung Yeh
Wu, Yu-Wei
Liu, Ju-Chi
Influenza Vaccination and the Risk of Ventricular Arrhythmias in Patients With Chronic Obstructive Pulmonary Disease: A Population-Based Longitudinal Study
title Influenza Vaccination and the Risk of Ventricular Arrhythmias in Patients With Chronic Obstructive Pulmonary Disease: A Population-Based Longitudinal Study
title_full Influenza Vaccination and the Risk of Ventricular Arrhythmias in Patients With Chronic Obstructive Pulmonary Disease: A Population-Based Longitudinal Study
title_fullStr Influenza Vaccination and the Risk of Ventricular Arrhythmias in Patients With Chronic Obstructive Pulmonary Disease: A Population-Based Longitudinal Study
title_full_unstemmed Influenza Vaccination and the Risk of Ventricular Arrhythmias in Patients With Chronic Obstructive Pulmonary Disease: A Population-Based Longitudinal Study
title_short Influenza Vaccination and the Risk of Ventricular Arrhythmias in Patients With Chronic Obstructive Pulmonary Disease: A Population-Based Longitudinal Study
title_sort influenza vaccination and the risk of ventricular arrhythmias in patients with chronic obstructive pulmonary disease: a population-based longitudinal study
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8551488/
https://www.ncbi.nlm.nih.gov/pubmed/34722665
http://dx.doi.org/10.3389/fcvm.2021.731844
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