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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.
GLOSSARY
- AMISTAD=
- Asymptomatic Myocardial Ischemia in STroke and Atherosclerotic Disease;
- CI=
- confidence interval;
- OPTIC=
- Outcomes in Patients with TIA and Cerebrovascular disease;
- PERFORM=
- Prevention of cerebrovascular and cardiovascular Events of ischemic origin with teRutroban in patients with a history oF ischemic strOke or tRansient ischeMic attack
Footnotes
PERFORM, OPTIC, and AMISTAD coinvestigators are listed on the Neurology® Web site at Neurology.org.
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Supplemental data at Neurology.org
- Received November 21, 2013.
- Accepted in final form February 24, 2014.
- © 2014 American Academy of Neurology
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Letters: Rapid online correspondence
- Inappropriate analytical method and exposure misclassification as probable causes of null findings in "Influenza vaccination and cardiovascular risk in patients with recent TIA and stroke"
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