Comments from Dr. Jun Chiong, FCCP
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Pneumococcal vaccine protects against cardiac and cerebrovascular events

BARCELONA – Influenza vaccine has been shown to provide protection against cardiovascular events, but can the same be said for pneumococcal vaccine?

Yes, particularly in the elderly and in patients at high baseline cardiovascular risk, according to a meta-analysis presented by Dr. Dimitrios Terentes-Printzios at the annual congress of the European Society of Cardiology.

lisafx/istockphoto.com
Pneumococcal vaccine may help protect against cardiovascular complications in elderly and high-risk patients.

He analyzed 11 published studies comprising 332,267 subjects followed for a mean of 20 months. Because the studies focused on different populations and in some cases reached conflicting conclusions, he performed a series of subgroup analyses to gain a clearer picture.

One of these analyses found that the cardioprotective effects of pneumococcal vaccination wane over time. In studies with follow-up of less than 1 year, the relative risk of total cardiovascular events was 0.72, meaning that patients who received pneumococcal vaccine had a significant 28% relative risk reduction compared with those who did not. In studies with follow-up in excess of 1 year, however, there was no cardioprotective effect, according to Dr. Terentes-Printzios of Athens Medical School.

Significant protection against total cardiovascular events was seen in elderly vaccinated patients, with a 20% relative risk reduction, and in subjects at high baseline cardiovascular risk, who had an 8% risk reduction if they received pneumococcal vaccine.

Breaking down the specific endpoints, subjects who got pneumococcal vaccine had a statistically significant 8% reduction in the risk of cardiovascular mortality. However, vaccination provided no significant protective effect against acute MI or cerebrovascular events except in the elderly, where the relative risk reductions were 10% and 14%, respectively.

These cardio- and cerebrovascular protective benefits of the pneumococcal vaccine can be viewed as added value, given that the primary reason physicians prescribe the vaccine is its demonstrated ability to reduce the risk of invasive pneumococcal infection by up to 60%.

Dr. Terentes-Printzios reported having no financial conflicts.

[email protected]

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Many patients with pneumonia are known to be at increased risk for cardiovascular events. The American Heart Association’s Get With The Guidelines – Resuscitation database found that in many stroke and cardiopulmonary arrests, pneumonia was a preexisting condition or was acquired during hospitalization.

Hence, it’s expected that preventing pneumonia with vaccination will also prevent subsequent death from cardiovascular reasons. Pneumonia vaccination will prevent not only cardiovascular events but death in general.

This study found more compelling reasons for us in the front line to vaccinate eligible candidates for flu and pneumonia, especially with fall already here.

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Many patients with pneumonia are known to be at increased risk for cardiovascular events. The American Heart Association’s Get With The Guidelines – Resuscitation database found that in many stroke and cardiopulmonary arrests, pneumonia was a preexisting condition or was acquired during hospitalization.

Hence, it’s expected that preventing pneumonia with vaccination will also prevent subsequent death from cardiovascular reasons. Pneumonia vaccination will prevent not only cardiovascular events but death in general.

This study found more compelling reasons for us in the front line to vaccinate eligible candidates for flu and pneumonia, especially with fall already here.

Body

Many patients with pneumonia are known to be at increased risk for cardiovascular events. The American Heart Association’s Get With The Guidelines – Resuscitation database found that in many stroke and cardiopulmonary arrests, pneumonia was a preexisting condition or was acquired during hospitalization.

Hence, it’s expected that preventing pneumonia with vaccination will also prevent subsequent death from cardiovascular reasons. Pneumonia vaccination will prevent not only cardiovascular events but death in general.

This study found more compelling reasons for us in the front line to vaccinate eligible candidates for flu and pneumonia, especially with fall already here.

Title
Comments from Dr. Jun Chiong, FCCP
Comments from Dr. Jun Chiong, FCCP

BARCELONA – Influenza vaccine has been shown to provide protection against cardiovascular events, but can the same be said for pneumococcal vaccine?

Yes, particularly in the elderly and in patients at high baseline cardiovascular risk, according to a meta-analysis presented by Dr. Dimitrios Terentes-Printzios at the annual congress of the European Society of Cardiology.

lisafx/istockphoto.com
Pneumococcal vaccine may help protect against cardiovascular complications in elderly and high-risk patients.

He analyzed 11 published studies comprising 332,267 subjects followed for a mean of 20 months. Because the studies focused on different populations and in some cases reached conflicting conclusions, he performed a series of subgroup analyses to gain a clearer picture.

One of these analyses found that the cardioprotective effects of pneumococcal vaccination wane over time. In studies with follow-up of less than 1 year, the relative risk of total cardiovascular events was 0.72, meaning that patients who received pneumococcal vaccine had a significant 28% relative risk reduction compared with those who did not. In studies with follow-up in excess of 1 year, however, there was no cardioprotective effect, according to Dr. Terentes-Printzios of Athens Medical School.

Significant protection against total cardiovascular events was seen in elderly vaccinated patients, with a 20% relative risk reduction, and in subjects at high baseline cardiovascular risk, who had an 8% risk reduction if they received pneumococcal vaccine.

Breaking down the specific endpoints, subjects who got pneumococcal vaccine had a statistically significant 8% reduction in the risk of cardiovascular mortality. However, vaccination provided no significant protective effect against acute MI or cerebrovascular events except in the elderly, where the relative risk reductions were 10% and 14%, respectively.

These cardio- and cerebrovascular protective benefits of the pneumococcal vaccine can be viewed as added value, given that the primary reason physicians prescribe the vaccine is its demonstrated ability to reduce the risk of invasive pneumococcal infection by up to 60%.

Dr. Terentes-Printzios reported having no financial conflicts.

[email protected]

BARCELONA – Influenza vaccine has been shown to provide protection against cardiovascular events, but can the same be said for pneumococcal vaccine?

Yes, particularly in the elderly and in patients at high baseline cardiovascular risk, according to a meta-analysis presented by Dr. Dimitrios Terentes-Printzios at the annual congress of the European Society of Cardiology.

lisafx/istockphoto.com
Pneumococcal vaccine may help protect against cardiovascular complications in elderly and high-risk patients.

He analyzed 11 published studies comprising 332,267 subjects followed for a mean of 20 months. Because the studies focused on different populations and in some cases reached conflicting conclusions, he performed a series of subgroup analyses to gain a clearer picture.

One of these analyses found that the cardioprotective effects of pneumococcal vaccination wane over time. In studies with follow-up of less than 1 year, the relative risk of total cardiovascular events was 0.72, meaning that patients who received pneumococcal vaccine had a significant 28% relative risk reduction compared with those who did not. In studies with follow-up in excess of 1 year, however, there was no cardioprotective effect, according to Dr. Terentes-Printzios of Athens Medical School.

Significant protection against total cardiovascular events was seen in elderly vaccinated patients, with a 20% relative risk reduction, and in subjects at high baseline cardiovascular risk, who had an 8% risk reduction if they received pneumococcal vaccine.

Breaking down the specific endpoints, subjects who got pneumococcal vaccine had a statistically significant 8% reduction in the risk of cardiovascular mortality. However, vaccination provided no significant protective effect against acute MI or cerebrovascular events except in the elderly, where the relative risk reductions were 10% and 14%, respectively.

These cardio- and cerebrovascular protective benefits of the pneumococcal vaccine can be viewed as added value, given that the primary reason physicians prescribe the vaccine is its demonstrated ability to reduce the risk of invasive pneumococcal infection by up to 60%.

Dr. Terentes-Printzios reported having no financial conflicts.

[email protected]

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Pneumococcal vaccine protects against cardiac and cerebrovascular events
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AT THE ESC CONGRESS 2014

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Key clinical point: Pneumococcal vaccine provides ancillary cardio- and cerebrovascular protective benefits, particularly in the elderly.

Major finding: Patients who got the pneumococcal vaccine had a statistically significant 8% reduction in the risk of cardiovascular mortality.

Data source: A meta-analysis of 11 studies comprising more than 332,000 patients.

Disclosures: The presenter reported having no conflicts of interest regarding this study.