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Oct. 7

— NEW YORK (Reuters Health) - A flu shot may lower the risk of fever, runny nose and hacking cough this winter, but it will not protect heart disease patients from a subsequent heart attack, researchers report.

Previous studies have suggested that a case of the flu can trigger heart attack and death from heart disease in susceptible patients. To investigate whether the vaccination protected patients, the researchers enrolled more than 1,300 people in their study. All patients had suffered a first heart attack and had survived for at least 3 months.

The influenza vaccination was not associated with the likelihood of recurrent heart attacks or death due to heart disease during the 2-year study, the researchers report in the October 1st issue of the American Journal of Epidemiology.

"These results suggest that the benefit of influenza vaccine for older adults does not extend to protection against recurrent coronary events," the study authors conclude.

However, elderly people should continue to receive the flu vaccine, which has been shown to lower rates of death and hospitalization for pneumonia, note Dr. Lisa A. Jackson from the University of Washington in Seattle and colleagues.

"Although our results do not suggest a benefit of influenza vaccine in the prevention of recurrent coronary events, the benefits of the vaccine in preventing serious complications of influenza infection are well documented," they write.

Previous reports have linked heart-related benefits to the flu vaccine. One study found that the flu vaccine was associated with a 50% reduction in the risk of out-of-hospital cardiac arrest due to heart disease. In cardiac arrest, the heart stops beating due to a heart attack or some other cause. Another report concluded that the flu vaccination reduced heart attack risk by 67%.

Inflammation can increase the risk of clot formation and the inflammatory process may cause fatty deposits within the arteries to rupture, leading to blockage of a heart artery and heart attack. Viral infections, such as the flu, may set off this inflammatory process, which would help explain any heart-protective effects of the flu vaccine.

SOURCE: American Journal of Epidemiology 2002;156:634-640.

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