Philippa C Lavallée1, Julien Labreuche1, Kim M Fox1, Pablo Lavados1, Heinrich Mattle1, Philippe Gabriel Steg1, Pierre Amarenco2. 1. From INSERM U 698 and Paris-Diderot University (P.C.L., J.L., P.G.S., P.A.), Sorbonne Paris Cité; Department of Neurology and Stroke Centre (P.C.L., J.L., P.A.) and Department of Cardiology (P.G.S.), AP-HP, Bichat University Hospital, Paris, France; NHLI Imperial College (K.M.F.), ICMS, Royal Brompton Hospital, London, UK; Unidad de Tratamiento de Ataque Cerebrovascular (P.L.), Clínica Alemana de Santiago Universidad del Desarrollo, Santiago, Chile; Neurologische Klinik und Poliklinik (H.M.), Universität Bern, Inselspital, Switzerland. 2. From INSERM U 698 and Paris-Diderot University (P.C.L., J.L., P.G.S., P.A.), Sorbonne Paris Cité; Department of Neurology and Stroke Centre (P.C.L., J.L., P.A.) and Department of Cardiology (P.G.S.), AP-HP, Bichat University Hospital, Paris, France; NHLI Imperial College (K.M.F.), ICMS, Royal Brompton Hospital, London, UK; Unidad de Tratamiento de Ataque Cerebrovascular (P.L.), Clínica Alemana de Santiago Universidad del Desarrollo, Santiago, Chile; Neurologische Klinik und Poliklinik (H.M.), Universität Bern, Inselspital, Switzerland. pierre.amarenco@bch.aphp.fr.
Abstract
OBJECTIVES: To determine whether current influenza vaccination is associated with reduced risk of major vascular events in patients with recent ischemic stroke or TIA of mainly atherothrombotic origin. METHODS: Data were pooled from 2 prospective cohort studies, the OPTIC Registry (n = 3,635) and the AMISTAD Study (n = 618), and from the randomized PERFORM Trial (n = 19,120), all of which included patients with recent ischemic stroke or TIA. Influenza vaccination status was determined in 23,110 patients. The primary outcome was a composite of nonfatal myocardial infarction, nonfatal stroke, or vascular death up to 2 years. Secondary outcomes were myocardial infarction and stroke separately. RESULTS: Influenza vaccination had no association with the primary outcome in the propensity score-matched cohort (hazard ratio 0.97, 95% confidence interval [CI] 0.85-1.11; p = 0.67) or in the propensity score-adjusted cohort (hazard ratio 1.00, 95% CI 0.89-1.12; p = 0.99). Similarly, the risk of stroke and myocardial infarction did not differ between the vaccinated group and the unvaccinated group; in the matched cohort, the hazard ratio was 1.01 (95% CI 0.88-1.17; p = 0.89) for stroke and 0.84 (95% CI 0.59-1.18; p = 0.30) for myocardial infarction. CONCLUSIONS: Influenza vaccination was not associated with reduced outcome events in patients with recent atherothrombotic ischemic stroke after considering all baseline characteristics (including concomitant medications) associated with influenza vaccination.
OBJECTIVES: To determine whether current influenza vaccination is associated with reduced risk of major vascular events in patients with recent ischemic stroke or TIA of mainly atherothrombotic origin. METHODS: Data were pooled from 2 prospective cohort studies, the OPTIC Registry (n = 3,635) and the AMISTAD Study (n = 618), and from the randomized PERFORM Trial (n = 19,120), all of which included patients with recent ischemic stroke or TIA. Influenza vaccination status was determined in 23,110 patients. The primary outcome was a composite of nonfatal myocardial infarction, nonfatal stroke, or vascular death up to 2 years. Secondary outcomes were myocardial infarction and stroke separately. RESULTS: Influenza vaccination had no association with the primary outcome in the propensity score-matched cohort (hazard ratio 0.97, 95% confidence interval [CI] 0.85-1.11; p = 0.67) or in the propensity score-adjusted cohort (hazard ratio 1.00, 95% CI 0.89-1.12; p = 0.99). Similarly, the risk of stroke and myocardial infarction did not differ between the vaccinated group and the unvaccinated group; in the matched cohort, the hazard ratio was 1.01 (95% CI 0.88-1.17; p = 0.89) for stroke and 0.84 (95% CI 0.59-1.18; p = 0.30) for myocardial infarction. CONCLUSIONS: Influenza vaccination was not associated with reduced outcome events in patients with recent atherothrombotic ischemic stroke after considering all baseline characteristics (including concomitant medications) associated with influenza vaccination.
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