Flu Vaccine Could Lower Risk of Ventricular Arrhythmia in Patients With COPD, Study Finds

The influenza vaccination may be associated with lower risks of ventricular arrhythmia (VA) in patients with chronic obstructive pulmonary disease (COPD), according to findings of a new study.

This is the first study to investigate the association between flu vaccine and the risk of VA in patients with COPD, the researchers from hospitals and universities in Taiwan wrote in Frontiers in Cardiovascular Medicine.

In the population-based longitudinal cohort study of 18,658 patients in Taiwan, the researchers retrospectively analyzed the data of patients with COPD who were 55 years and older from the National Health Insurance Research Database from January 2001 to December 2012.

They divided the patients into vaccinated and unvaccinated groups, and then utilized time-varying Cox proportional hazards regression to assess the time to event hazards of influenza vaccination exposure.

The investigators discovered that the influenza vaccination was associated with a significantly lower risk of VA occurrence in patients with COPD—specifically those aged 55 to 74 years.

They found that the risk of VA occurrence was significantly lower in the vaccinated group during flu season and all seasons (adjusted HR [aHR], 0.62; 95% CI, 0.41-0.95; aHR, 0.69; 95% CI, 0.44-1.08; and aHR, 0.65; 95% CI, 0.48-0.89, in the influenza season, noninfluenza season, and all seasons, respectively).

In addition, more than 1 receipt of vaccination was associated with lower risk of VA occurrence in patients with a higher CHA₂DS₂-VASc (congestive heart failure, hypertension, diabetes, stroke or transient ischemic attack, vascular disease, age, sex) score. Among patients with CHA₂DS₂-VASc scores of 2 to 3, receiving 1, 2 or 3, doses of influenza vaccination were associated with lower risk of VA occurrence in all seasons (aHR, 0.28; 95% CI, 0.10-0.80; aHR, 0.27; 95% CI, 0.10-0.68, respectively).

Patients also had a lower risk of VA occurrence after the first time of vaccination if they did not have a history of stroke, ischemic heart disease, peripheral vascular disease, diabetes, and heart failure. “After receiving 2 to 3 times of vaccination, a lower risk of VA occurrence was observed among patients without these medical histories except heart failure and ischemic heart disease,” the researchers wrote.

Other studies have found that the flu vaccine decreases not only the risk of developing atrial fibrillation but also the risk of primary cardiac arrest in patients without a history of cardiovascular disease, the authors noted.

“In the present study, the risk of developing VA decreased significantly among patients with COPD who underwent vaccination. Among the patients with a concurrent diagnosis of asthma, which indicated the possibility of complex airway and lung parenchymal condition, also benefit from influenza vaccination,” they wrote.

They noted, however, that in elderly patients (75 years and older), the risk of VA occurrence after the flu vaccine did not significantly decrease.

“The elderly patients with COPD and ventricular arrhythmia had a high prevalence of multiple risk factors such as hypertension, coronary artery disease, and diabetes. The increased risk of VA development was possible because of increasing comorbidities and fragile health in these patients,” the researchers wrote.

“In addition, the effectiveness of vaccination might be lowered in elderly patients because of lower immune response to influenza vaccination compared with younger patients,” they added.

Reference

Chen CC, Lin CH, Hao WR. Influenza vaccination and the risk of ventricular arrhythmias in patients with chronic obstructive pulmonary disease: a population-based longitudinal study. Front Cardiovasc Med. Published online October 14, 2021. doi:10.3389/fcvm.2021.731844