Clinical effectiveness of pneumococcal vaccination against acute myocardial infarction and stroke in people over 60 years: the CAPAMIS study, one-year follow-up Full Text
BMC Public Health, 04/11/2012
Vila–Corcoles A et al. – The data supports a benefit of PPV23 against ischaemic stroke among the general population over 60 years, suggesting a possible protective role of pneumococcal vaccination against some acute thrombotic events.Methods
- Population–based prospective cohort study conducted from December 1, 2008 until November 30, 2009, including all individuals [greater than or equal to] 60 years–old assigned to nine Primary Care Centres in Tarragona, Spain (N = 27,204 individuals).
- Primary outcomes were hospitalisation for acute myocardial infarction and/or ischaemic stroke.
- All cases were validated by checking clinical records.
- The association between pneumococcal vaccination and the risk of each outcome was evaluated by Multivariable Cox proportional–hazard models (adjusted by age, sex, influenza vaccine status, presence of comorbidities and cardiovascular risk factors).
- Cohort members were followed for a total of 26,444 person–years, of which 34% were for vaccinated subjects.
- Overall incidence rates (per 1000 person–years) were 4.9 for myocardial infarction and 4.6 for ischaemic stroke.
- In the multivariable analysis, vaccination was associated with a marginally significant 35% lower risk of stroke (hazard ratio [HR]: 0.65; 95% confidence interval [CI]: 0.42–0.99; p = 0.046).
- The authors found no evidence for an association between pneumococcal vaccination and reduced risk of myocardial infarction (HR: 0.83; 95% CI: 0.56–1.22; p = 0.347).