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Influenza vaccination in patients with heart failure : a systematic review and meta-analysis of observational studies

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dc.contributor.authorRodrigues, Bárbara Sucena
dc.contributor.authorDavid, Cláudio
dc.contributor.authorCosta, João
dc.contributor.authorFerreira, Joaquim J
dc.contributor.authorPinto, Fausto J.
dc.contributor.authorCaldeira, Daniel
dc.date.accessioned2019-09-03T15:43:30Z
dc.date.available2019-09-03T15:43:30Z
dc.date.issued2019
dc.description© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.pt_PT
dc.description.abstractOBJECTIVE: Despite the progression of treatments over decades, heart failure (HF) is a disease with high morbidity, mortality and economic burden. Influenza infection is an important trigger for cardiovascular (CV) events, including HF. Influenza vaccination has been seen to reduce the risk of CV mortality in patients with coronary disease, but the effect in patients with HF is still unclear. Therefore, we conducted a systematic review to evaluate the effect of influenza vaccination in the morbimortality of patients with HF. METHODS: MEDLINE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Health Technology Assessment and PsycINFO databases (December 2018) were searched for longitudinal studies evaluating influenza vaccination compared with a non-vaccination control group in patients with HF. The risk of bias was assessed according to the ROBINS-I tool. We performed a random-effects meta-analysis to estimate the pooled HRs with 95% CIs, and heterogeneity was evaluated using the I2 statistics. RESULTS: Six cohort studies evaluating 179 158 patients with HF were included in the meta-analysis. Influenza vaccination was associated with a lower risk of all-cause mortality (HR=0.83; 95% CI 0.76 to 0.91; I2=75%). The effect of the influenza vaccination was not statistically significant in a pooled analysis of CV mortality (HR=0.92, 95% CI 0.73 to 1.15; 2 studies) and of all-cause hospitalisations (HR=1.01, 95% CI 0.92 to 1.11; 2 studies). The majority of outcomes in the included studies had a serious risk of bias and almost all evaluated outcomes had very low Grading of Recommendation, Assessment, Development and Evaluation (GRADE) evidence. CONCLUSIONS: Influenza vaccination was associated with a significant decrease in all-cause mortality risk in patients with HF.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationHeart 2019;0:1–8pt_PT
dc.identifier.doi10.1136/heartjnl-2019-315193pt_PT
dc.identifier.issn1355-6037
dc.identifier.urihttp://hdl.handle.net/10451/39423
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherBMJ Publishing Grouppt_PT
dc.relation.publisherversionhttps://heart.bmj.com/pt_PT
dc.titleInfluenza vaccination in patients with heart failure : a systematic review and meta-analysis of observational studiespt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.titleHeartpt_PT
person.familyNameSucena Rodrigues
person.familyNameAntunes David
person.familyNameCosta
person.familyNameFerreira
person.familyNamePinto
person.familyNameCaldeira
person.givenNameBárbara
person.givenNameCláudio Virgílio
person.givenNameJoão
person.givenNameJoaquim J
person.givenNameFausto J.
person.givenNameDaniel
person.identifier480560
person.identifier1624753
person.identifier1308889
person.identifier.ciencia-id0C16-4DE0-15E7
person.identifier.ciencia-id7D15-5CD6-6159
person.identifier.ciencia-idC311-AEDD-6DBB
person.identifier.ciencia-idAA19-EC35-8D01
person.identifier.orcid0000-0001-6873-6143
person.identifier.orcid0000-0002-8749-8598
person.identifier.orcid0000-0002-5831-4921
person.identifier.orcid0000-0003-3950-5113
person.identifier.orcid0000-0002-8034-4529
person.identifier.orcid0000-0002-2520-5673
person.identifier.ridG-9363-2015
person.identifier.scopus-author-id55499748300
person.identifier.scopus-author-id7403252466
person.identifier.scopus-author-id7102740158
person.identifier.scopus-author-id36623384200
rcaap.rightsrestrictedAccesspt_PT
rcaap.typearticlept_PT
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