American Journal of Epidemiology, Vol 152, Issue 7 674-677, Copyright © 2000 by Oxford University Press
DS Siscovick, TE Raghunathan, D Lin, S Weinmann, P Arbogast, RN Lemaitre, BM Psaty, R Alexander and LA Cobb
Influenza epidemics are associated with an excess of mortality not only
from respiratory diseases but also from other causes, and cardiovascular
mortality increases abruptly during influenza epidemics, with little
evidence of a lag period. In a population-based case- control study, the
authors examined whether influenza vaccination was associated with a
reduced risk of out-of-hospital primary cardiac arrest (PCA), a major
contributor to cardiovascular mortality in the community. Cases of PCA (n =
342) without prior heart disease or life- threatening comorbidity that
occurred in King County, Washington, were identified from paramedic
incident reports from October 1988 to July 1994. Demographically similar
controls (n = 549) were identified from the community by using random digit
dialing. Spouses of subjects were interviewed to assess treatment with
influenza vaccine during the previous year and other risk factors. After
adjustment for demographic, clinical, and behavioral risk factors,
influenza vaccination was associated with a reduced risk of PCA (odds ratio
= 0.51, 95 percent confidence interval: 0.33, 0.79). The authors suggest
that while the association of influenza vaccination with a reduced risk of
PCA is consistent with cohort studies of influenza vaccination and total
mortality, further studies are needed to determine whether the observed
association reflects protection or selection.
ARTICLES
Influenza vaccination and the risk of primary cardiac arrest
Department of Medicine, University of Washington, Seattle, USA. dsisk@u.washington.edu
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