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Influenza vaccination reduces hemorrhagic stroke risk in patients with atrial fibrillation: A population-based cohort study
- Source :
- International journal of cardiology. 232
- Publication Year :
- 2016
-
Abstract
- Purpose The risk of hemorrhagic stroke in patients with atrial fibrillation (AF) is low but the consequences of its occurrence are extremely severe. In this study, we investigated the association of influenza vaccination with the risk of hemorrhagic stroke to develop an efficient strategy for reducing this risk in patients with AF. Methods In this study, data were retrieved from the Taiwan National Health Insurance Research Database. The study cohort comprised all patients who received a diagnosis of AF ( n =14,454) before January 1, 2005 (index date) and were followed until December 31, 2012. Propensity scores were calculated using a logistic regression model to determine the effects of vaccination by accounting for covariates that predict receiving the intervention (vaccine). A time-dependent Cox proportional hazard model was used to calculate the hazard ratios (HRs) for hemorrhagic stroke in vaccinated and unvaccinated patients with AF. Results The study population comprised 6570 patients who did (2547 [38.77%]) and did not receive (4023 [61.23%]) influenza vaccination. The adjusted HRs (aHRs) for hemorrhagic stroke were lower in the vaccinated patients than in the unvaccinated patients (influenza season, noninfluenza season, and all seasons: aHRs=0.97 [0.59–1.60], 0.51 [0.30–0.87], and 0.72 [0.50–1.03], respectively). Conclusions Influenza vaccination exerts dose–response and synergistic protective effects against hemorrhagic stroke in patients with AF who have a high risk of hemorrhagic stroke (i.e., male sex, age≥75years, Charlson comorbidity index ≥3, and hypertension) and reduces the incidence of hemorrhagic stroke.
- Subjects :
- Influenzavirus A
medicine.medical_specialty
Taiwan
030204 cardiovascular system & hematology
Risk Assessment
03 medical and health sciences
0302 clinical medicine
Risk Factors
Internal medicine
Atrial Fibrillation
Influenza, Human
medicine
Humans
030212 general & internal medicine
Intensive care medicine
Stroke
Aged
Retrospective Studies
Proportional hazards model
business.industry
Incidence (epidemiology)
Incidence
Hazard ratio
Vaccination
Atrial fibrillation
Middle Aged
medicine.disease
Prognosis
Survival Rate
Influenza Vaccines
Population Surveillance
Cohort
Population study
Female
Cardiology and Cardiovascular Medicine
business
Intracranial Hemorrhages
Follow-Up Studies
Subjects
Details
- ISSN :
- 18741754
- Volume :
- 232
- Database :
- OpenAIRE
- Journal :
- International journal of cardiology
- Accession number :
- edsair.doi.dedup.....7646dd214dd401ea24b8b5b238c375ca