CDC Reports: Cardiac Patients at High Risk for Flu Hospitalization

Dear Clinician: Here is the information you requested (sponsored by Centers for Disease Control and Prevention [CDC]). Influenza can be a serious illness in your patients with heart disease. Studies show that your strong recommendation for flu vaccination significantly increases a patient's willingness to get a flu vaccine. The CDC recommends annual vaccination for all adults and children 6 months and older, Vaccination is, especially important for those at highest risk of severe flu illness, hospitalization and death, such as people with heart disease.1 An annual flu vaccine is recommended by the American Heart Association, and the American College of Cardiology for persons with cardiac disease for secondary prevention of cardiac-related events in persons with coronary and other atherosclerotic vascular disease.2 Cardiac disease has long been recognized as a risk factor for complications from the flu, including hospitalization and death. According to a three-year study conducted from 2005 through 2008, more than 1/3 of adults hospitalized with laboratory-confirmed influenza had cardiac disease.3 During the 2010-11 influenza season, among adults hospitalized with lab-confirmed flu, 38 percent had underlying cardiac disease—and cardiac disease was the most often reported high risk condition. Data from the 2009 H1N1 pandemic also support the contribution of cardiac disease to influenza hospitalizations.4,5 A study in Canada published in 2011, was conducted among patients with lab-confirmed flu, reflecting 2009 H1N1 flu cases. In this study, having cardiac disease was associated with a 2.7 times increased risk of flu-related hospitalization.4 Benefits of Influenza Vaccine Among Patients With Cardiac Disease Two randomized studies have been conducted among patients with cardiac disease, both of which demonstrated a reduction in cardiovascular events in vaccinated patients. A study in Argentina published in 2004 was conducted among patients with recent ischemic events or who were undergoing angioplasty. The study found significant reductions in cardiovascular deaths at one year, from 17 percent in unvaccinated patients to six percent among vaccinated patients.6,7 In a study in Thailand published in 2011, patients were included if they were recently hospitalized with acute coronary syndrome. This study found a reduction in a combined endpoint of major cardiovascular events, including death, from 19 percent among those who were unvaccinated to 9.5 percent among those who were vaccinated against influenza.8 For more information, visit the CDC website: www.cdc.gov/flu. You can order free materials, review the ACIP guidelines, or find further information for yourself, your staff, and your patients. References CDC. Prevention and control of influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices (ACIP), 2010. MMWR. 2010;59(rr08);1-62. Davis MM, et al. Influenza vaccination as secondary prevention for cardiovascular disease. Circulation. 2006;114:1549-1553. Dao CN, et al. Adult hospitalizations for laboratory-positive influenza during 2005-06 through 2007-08 seasons in the United States. J Infect Dis. 2010;202:881-8. Gilca R, et al. Risk factors for hospitalization and severe outcomes of 2009 pandemic H1N1 influenza in Quebec, Canada. Influenza Other Respir Viruses. 2011;5:247–255. Fowlkes AL, et al. Epidemiology of 2009 pandemic influenza A (H1N1) deaths in the United States. Clin Infect Dis. 2011;52(Suppl 1):S60-8. Gurfinkel EP, et al. Flu vaccination in acute coronary syndromes and planned percutaneous coronary interventions (FLUVACS) Study. Eur Heart J. 2004;25:25–31. Gurfinkel EP, et al. Two-year follow-up of the FLU vaccination acute coronary syndromes (FLUVACS) registry. J Am Coll Cardiol. 1995;31:28-32. Phrommintikul A, et al. Influenza vaccination reduced cardiovascular events in patients with acute coronary syndrome. Euro Heart J. 2011;32:1730-5. The above message was sponsored by Message Sponsor, who is solely responsible for its content. Centers for Disease Control and Prevention (CDC) 1600 Clifton Road Atlanta, GA 30333 www.cdc.gov You have received this content because you requested follow-up information to a DocAlert message delivered through the Epocrates system. If you do not want to receive an email from this sponsor, please do not select "Email More Info" in the DocAlert message sent on behalf of this sponsor. The sponsor name can be found in the DocAlert message. For more information about DocAlert messages, please click here. All trademarks referenced are properties of their respective owners.

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