A new European Society of Cardiology Clinical Consensus Statement highlights the role of vaccination in preventing cardiovascular events.
The statement reviews growing evidence that immunization against influenza, COVID-19, pneumococcus, herpes zoster, and respiratory syncytial virus (RSV) can reduce the risk of major adverse cardiovascular events, such as heart attack, stroke, and heart failure.
The report explains that infections increase cardiovascular risk by triggering inflammation, destabilizing plaques, and impairing myocardial function (MI). For example, each 5% increase in influenza activity has been linked to a 24% rise in hospitalizations. Influenza alone carries a 3.9% population-attributable risk for coronary artery disease.
Several randomized trials and meta-analyses support a connection between vaccination and fewer cardiovascular events. In the Influenza Vaccination after Myocardial Infarction trial, influenza vaccination within 72 hours of MI reduced cardiovascular death, recurrent infarction, and stent thrombosis by up to 41%. A meta-analysis involving over 9,000 patients showed a 45% reduction in all-cause mortality among vaccinated patients with acute coronary syndromes.
Influenza vaccination may also benefit patients with heart failure and other chronic conditions. Although the IVVE trial did not meet its primary endpoint, it found reduced pneumonia and hospitalizations in vaccinated patients. High-dose influenza vaccines have shown potential in elderly populations and are under further study in trials such as DANFLU-2.
Vaccines for other infections may also be cardioprotective. The herpes zoster vaccine has been associated with over 50% lower cardiovascular event risk after shingles. Pneumococcal vaccination, which is 60% to 70% effective against invasive disease, has been linked to a 10% reduction in cardiovascular events in adults aged 65 and older.
Patients with cardiovascular disease are especially vulnerable to the complications of infection. Vaccination is safe in this population and is recommended by clinical guidelines. Both the European Sociery of Cardiology and the American College of Cardiology/American Heart Association advise annual influenza vaccination and support pneumococcal and COVID-19 vaccination for high-risk patients.
Among heart transplant recipients, vaccination coverage remains low, despite data showing reduced pneumonia admissions and mortality. The statement recommends integrating vaccination into routine cardiovascular care, including administration during hospitalization for acute events such as MI.
While evidence for influenza, COVID-19, and pneumococcal vaccines is robust, additional research is needed to evaluate the cardiovascular impact of other vaccines such as RSV and human papillomavirus. The authors call for more trials to assess vaccine efficacy in broader cardiovascular populations.
The consensus concludes that increasing vaccination rates in patients with cardiovascular disease may help lower global mortality and reduce the overall burden of heart disease.
Full disclosures can be found in the published study.
Source: European Heart Journal