Influenza vaccination is associated with a decreased risk of atrial fibrillation: A systematic review and meta-analysis

Menglu Liu; Weichun Lin; Tiangang Song; Huilei Zhao; Jianyong Ma; Yujie Zhao; Peng Yu; Zhiwei Yan

doi:10.3389/fcvm.2022.970533

Influenza vaccination is associated with a decreased risk of atrial fibrillation: A systematic review and meta-analysis

Front Cardiovasc Med. 2022 Oct 20:9:970533. doi: 10.3389/fcvm.2022.970533. eCollection 2022.

Authors

Menglu Liu¹, Weichun Lin², Tiangang Song³, Huilei Zhao⁴, Jianyong Ma⁵, Yujie Zhao¹, Peng Yu³, Zhiwei Yan⁶

Affiliations

¹ Department of Cardiology, Seventh People's Hospital of Zhengzhou, Zhengzhou, China.
² Department of Gastroenterology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
³ Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Nanchang University, Nanchang, China.
⁴ Department of Anesthesiology, The Third Hospital of Nanchang, Nanchang, China.
⁵ Department of Pharmacology and Systems Physiology, College of Medicine, University of Cincinnati, Cincinnati, OH, United States.
⁶ Department of Sports Rehabilitation, College of Human Kinesiology, Shenyang Sport University, Shenyang, China.

Abstract

Background: Evidence from longitudinal studies has shown that influenza infection is linked to an increased risk of arrhythmia. Therefore, we aimed to assess the role of influenza vaccination in arrhythmia prevention.

Materials and methods: The PubMed, Embase, and Cochrane Library databases were searched to identify studies that investigated the potential effects of the influenza vaccine on arrhythmia risk published until October 25th, 2021. The study was registered with PROSPERO (CRD42022300815).

Results: One RCT with 2,532 patients and six observational studies with 3,167,445 patients were included. One RCT demonstrated a non-significant benefit of the influenza vaccine against arrhythmias [odds ratio (OR) = 0.43, 95% confidence interval (CI): 0.11-1.64; P = 0.20] in patients after myocardial infarction or those with high-risk stable coronary heart disease. A meta-analysis based on observational studies showed that vaccination was associated with a significantly lower risk of arrhythmia (OR: 0.82, 95% CI: 0.70-0.97; P = 0.02; I ² = 76%). Additionally, subgroup analysis showed a decreased risk of atrial fibrillation (AF) (OR: 0.94, 95% CI: 0.90-0.98; P = 0.006; I ² = 0%) and a non-significant but positive trend concerning ventricular arrhythmias (VAs) (OR: 0.68, 95% CI: 0.42-1.11; P = 0.12; I ² = 85%) after influenza vaccination.

Conclusion: Based on the current evidence, influenza vaccination may be associated with a reduced risk of arrhythmia, especially AF. Influenza vaccination may be an effective tool for the prevention of arrhythmias. The effect of influenza vaccination on the risk of VAs and arrhythmias in patients at low risk for cardiovascular diseases should be further studied.

Systematic review registration: [https://www.crd.york.ac.uk/PROSPERO/], identifier [CRD42022300815].

Keywords: arrhythmia; atrial fibrillation; influenza vaccination; meta-analysis; ventricular arrhythmia.

Publication types

Systematic Review