Influenza vaccination is associated with reduced cardiovascular mortality in adults with diabetes: A nationwide cohort study
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Influenza vaccination is associated with reduced cardiovascular mortality in adults with diabetes : A nationwide cohort study. / Modin, Daniel; Claggett, Brian; Køber, Lars; Schou, Morten; Jensen, Jens Ulrik Stæhr; Solomon, Scott D.; Vardeny, Orly; Knop, Filip Krag; Nielsen, Susanne Dam; Fralick, Michael; Torp-Pedersen, Christian; Gislason, Gunnar; Biering-Sørensen, Tor.
In: Diabetes Care, Vol. 43, No. 9, 2020, p. 2226-2233.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Influenza vaccination is associated with reduced cardiovascular mortality in adults with diabetes
T2 - A nationwide cohort study
AU - Modin, Daniel
AU - Claggett, Brian
AU - Køber, Lars
AU - Schou, Morten
AU - Jensen, Jens Ulrik Stæhr
AU - Solomon, Scott D.
AU - Vardeny, Orly
AU - Knop, Filip Krag
AU - Nielsen, Susanne Dam
AU - Fralick, Michael
AU - Torp-Pedersen, Christian
AU - Gislason, Gunnar
AU - Biering-Sørensen, Tor
PY - 2020
Y1 - 2020
N2 - OBJECTIVE Recent influenza infection is associated with an increased risk of atherothrombotic events, including acute myocardial infarction (AMI) and stroke. Little is known about the association between influenza vaccination and cardiovascular outcomes in patients with diabetes. RESEARCH DESIGN AND METHODS We used nationwide register data to identify patients with diabetes in Denmark during nine consecutive influenza seasons in the period 2007–2016. Diabetes was defined as use of glucose-lowering medication. Patients who were not 18–100 years old or had ischemic heart disease, heart failure, chronic obstructive lung disease, cancer, or cerebrovascular disease were excluded. Patient exposure to influenza vaccination was assessed before each influenza season. We considered the outcomes of death from all causes, death from cardiovascular causes, and death from AMI or stroke. For each season, patients were monitored from December 1untilApril1thenextyear. RESULTS A total of 241,551 patients were monitored for a median of four seasons (interquartile range two to eight seasons) for a total follow-up of 425,318 person-years. The vaccine coverage during study seasons ranged from 24% to 36%. During follow-up, 8,207 patients died of all causes (3.4%), 4,127 patients died of cardiovascular causes (1.7%), and 1,439 patients died of AMI/stroke (0.6%). After adjustment for confounders, vaccination was significantly associated with reduced risks of all-cause death (hazard ratio [HR] 0.83, P < 0.001), cardiovascular death (HR 0.84, P < 0.001), and death from AMI or stroke (HR 0.85, P = 0.028) and a reduced risk of being admitted to hospital with acute complications associated with diabetes (diabetic ketoacidosis, hypoglycemia, or coma) (HR 0.89, P = 0.006). CONCLUSIONS In patients with diabetes, influenza vaccination was associated with a reduced risk of all-cause death, cardiovascular death, and death from AMI or stroke. Influenza vaccination may improve outcome in patients with diabetes.
AB - OBJECTIVE Recent influenza infection is associated with an increased risk of atherothrombotic events, including acute myocardial infarction (AMI) and stroke. Little is known about the association between influenza vaccination and cardiovascular outcomes in patients with diabetes. RESEARCH DESIGN AND METHODS We used nationwide register data to identify patients with diabetes in Denmark during nine consecutive influenza seasons in the period 2007–2016. Diabetes was defined as use of glucose-lowering medication. Patients who were not 18–100 years old or had ischemic heart disease, heart failure, chronic obstructive lung disease, cancer, or cerebrovascular disease were excluded. Patient exposure to influenza vaccination was assessed before each influenza season. We considered the outcomes of death from all causes, death from cardiovascular causes, and death from AMI or stroke. For each season, patients were monitored from December 1untilApril1thenextyear. RESULTS A total of 241,551 patients were monitored for a median of four seasons (interquartile range two to eight seasons) for a total follow-up of 425,318 person-years. The vaccine coverage during study seasons ranged from 24% to 36%. During follow-up, 8,207 patients died of all causes (3.4%), 4,127 patients died of cardiovascular causes (1.7%), and 1,439 patients died of AMI/stroke (0.6%). After adjustment for confounders, vaccination was significantly associated with reduced risks of all-cause death (hazard ratio [HR] 0.83, P < 0.001), cardiovascular death (HR 0.84, P < 0.001), and death from AMI or stroke (HR 0.85, P = 0.028) and a reduced risk of being admitted to hospital with acute complications associated with diabetes (diabetic ketoacidosis, hypoglycemia, or coma) (HR 0.89, P = 0.006). CONCLUSIONS In patients with diabetes, influenza vaccination was associated with a reduced risk of all-cause death, cardiovascular death, and death from AMI or stroke. Influenza vaccination may improve outcome in patients with diabetes.
U2 - 10.2337/dc20-0229
DO - 10.2337/dc20-0229
M3 - Journal article
C2 - 32647052
AN - SCOPUS:85090171901
VL - 43
SP - 2226
EP - 2233
JO - Diabetes Care
JF - Diabetes Care
SN - 0149-5992
IS - 9
ER -
ID: 250969925