Clinical effectiveness of pneumococcal vaccination against acute myocardial infarction and stroke in people over 60 years: The CAPAMIS study, one-year follow-up

Angel Vila-Corcoles, Olga Ochoa-Gondar, Teresa Rodriguez-Blanco, Antonia Gutierrez-Perez, Angel Vila-Rovira, Frederic Gomez, Xavier Raga, Cinta De Diego, Eva Satue, Elisabet Salsench

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    Abstract

    Background: Conflicting results have been recently reported evaluating the relationship between pneumococcal vaccination and the risk of thrombotic vascular events. This study assessed the clinical effectiveness of the 23-valent polysaccharide pneumococcal vaccine (PPV23) against acute myocardial infarction and ischaemic stroke in older adults. Methods. Population-based prospective cohort study conducted from December 1, 2008 until November 30, 2009, including all individuals ≥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). Results: 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). We 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). Conclusions: Our 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. © 2012 Vila-Corcoles et al; licensee BioMed Central Ltd.
    Original languageEnglish
    Article number222
    JournalBMC Public Health
    Volume12
    Issue number1
    DOIs
    Publication statusPublished - 23 Mar 2012

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    Vila-Corcoles, A., Ochoa-Gondar, O., Rodriguez-Blanco, T., Gutierrez-Perez, A., Vila-Rovira, A., Gomez, F., Raga, X., De Diego, C., Satue, E., & Salsench, E. (2012). Clinical effectiveness of pneumococcal vaccination against acute myocardial infarction and stroke in people over 60 years: The CAPAMIS study, one-year follow-up. BMC Public Health, 12(1), [222]. https://doi.org/10.1186/1471-2458-12-222