You would have a therapy once a year that promises, clinical trials in hand, to reduce the risk of death from heart failure by 20 percent and the risk of heart failure by 27 percent. heart attacklower the danger of worsening atrial fibrillation or of seeing it appear, limit the possibility that the same arrhythmia leads to stroke ischemic, reduce the risk of a heart patient going to hospital by 20 percent? If the answer is positive, think that according to research these results are obtained with prevention. His name? Influenza vaccine.
The guidelines of the European Society
Think that in patients with known coronary heart disease the effectiveness of the influenza vaccination for the prevention of recurrence of coronary events was comparable to that of the therapies recommended in secondary prevention. So much so that the ischemic heart disease guidelines of the European Society of Cardiology give influenza vaccination a class 1 recommendation, the same level that drugs that are taken regularly for the prevention of cardiovascular problems have.
What is the risk without the vaccine
Let’s go back to the figures. 28% reduction in the relative risk of mortality from all causes in the 20 months following follow-up. 18% decrease in the relative risk of death from cardiovascular problems and 13% decrease in major cardiovascular events, such as heart attack or stroke. We are talking about heart patients who have been vaccinated in comparison with others who have not protected themselves. These percentages emerge from an analysis of 16 studies for a total of almost 240,000 patients with heart and arterial problems, the value of vaccination for influenza in this population is immediately appreciated. The drop in risk for those who get vaccinated also emerges from an American research conducted in hospitalized patients in the period 2010-2017 with a diagnosis of laboratory-confirmed influenza. In the unprotected population, an acute cardiovascular event occurred in one in eight patients with 31% of patients requiring hospitalization in the ICU and a death rate of 7%.
Covid: no, for the heart it is not just a flu
by Federico Mereta
Because the heart risks
When the virus enters the body it triggers an inflammatory reaction. And precisely this response, together with the direct action of the virus on heart cells, would be at the basis of the increasing risk for the heart and vessels. “Several pathogens, including influenza viruses, can modulate the inflammatory response and influence the biology of the atherosclerotic plaque up to inducing rupture and causing a type 1 myocardial infarction – he explains Francesco Prati, President of the Center Foundation for the Fight against Heart Attack. Inflammatory cytokines are released into the circulation, such as interleukins 1, 6 and 8 and the Tumor Necrosis Factor, which are able to activate inflammatory cells within the atherosclerotic plaque “.
The risk of thrombosis increases
As if that weren’t enough, the increased tendency to blood clotting associated with acute infections further increases the risk of coronary thrombosis at the site of plaque rupture. “Influenza viruses also seem to have a particular tropism for vascular structures, as suggested in experimental models of atherosclerosis accelerated by their specific localization at the level of the fibrolipidic plaques even in the absence of apparent viremia – continues Prati. The state of increased activity systemic inflammatory and plaque level inflammation, hypercoagulability and endothelial and platelet dysfunction / activation tends to persist even after the clinical resolution of the acute infection “.
Heart door
Flu vaccine: last call for those with a heart at risk (and not only)
by Federico Mereta
Overwork with fever
It should also be said that in the presence of a pre-existing cardiovascular disease, influenza can contribute to the development of a myocardial infarction through an increase in the metabolic demands of the myocardial tissue for fever and tachycardia and the possible induction of hypoxemia, i.e. for the reduction of oxygen available in the blood. The increase in heart rate that accompanies febrile states reduces the diastole time and consequently the coronary perfusion that occurs most during this phase of the cardiac cycle. In the elderly, the perfusion deficit may be further exacerbated by the presence of coronary stenosis or even by toxin-mediated vasoconstriction. Unfortunately, all this risks adding to the direct damage by the virus on myocardial cells.
Vaccine also immediately after the heart attack
In the context of the conference “Knowing and taking care of the heart” underway in Florence there is also talk of the opportunity to vaccinate in the hospital for the flu who has just had a heart attack. Pushing this path are the results of the IAMI study (Influenza Vaccination After Myocardial Infarction), who evaluated the protective efficacy of influenza vaccination versus placebo in reducing major cardiovascular events in a cohort of 2571 patients, in almost all cases with myocardial infarction (only 0.3% with stable high-risk coronary heart disease), in a time interval of 12 months. Influenza vaccination within 72 hours of hospitalization for myocardial infarction or invasive coronary procedure resulted in a 28% reduction in primary outcome risk and a 41% reduction in all-cause mortality. All this, without any increase in serious adverse events.
Long Covid, alarming data: the risks of embolism and thrombosis multiplied even months after infection
by Federico Mereta
