IAMI: Influenza Vaccine Improved Outcomes, Reduced Risk of Death in High-Risk Patients After Acute MI or PCI

American College of Cardiology Foundation

October 27, 2021

High-risk patients with coronary artery disease who received an influenza vaccine in the hospital following an acute myocardial infarction (MI) or PCI had lower risk of all-cause death, MI, or stent thrombosis at 12 months compared with placebo, according to findings from the IAMI trial presented at ESC Congress 2021. The results were also published in Circulation.

The trial, which was halted early due to the COVID-19 pandemic, enrolled 2,532 patients (58% of target enrollment) who were then randomized on a 1:1 ratio to receive the influenza vaccine or placebo within 72 hours of an invasive coronary procedure or hospitalization. The median age of participants was 60 years and 18% were women. The primary endpoint was a composite of all-cause death, MI, or stent thrombosis at 12 months. A hierarchical testing strategy was used for the key secondary outcomes of all-cause death, cardiovascular death, MI and stent thrombosis.

Overall results found the primary composite endpoint occurred in 5.3% of patients in the vaccine group (n=67) compared with 7.2% in the placebo group (n=91). In terms of secondary endpoints, rates of both death from any cause and cardiovascular death were lower in the vaccine group compared with the placebo group (2.9% vs. 4.9% and 2.7% vs. 4.5%, respectively). Researchers observed no difference between groups in the rate of MI and serious adverse events were rare among all participants.

"Our findings suggest that influenza vaccination should be considered as part of in-hospital treatment after myocardial infarction," said principal investigator Ole Fröbert, MD, of Örebro University, Sweden. He and colleagues also note their findings underscore the importance of an annual seasonal influenza vaccination in patients with cardiovascular disease.

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