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| ID | Type | Description | Link |
|---|---|---|---|
| SMMC- 13861008B |
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This study wishes to understand:
Influenza infection may become complicated in patients with chronic conditions, including coronary artery disease (CAD) [1]. Influenza vaccination is now recommended as part of comprehensive secondary prevention in individuals with coronary and other atherosclerotic vascular disease (evidence level: Class I, Level B) [2]. Although there is controversial evidence pro [3,4] and against [5] the efficacy of influenza vaccination in protecting CAD population against cardiovascular events, the efficacy of vaccine in actual reduction in episodes of influenza infection and its fatal complications in CAD patients has not been, to our knowledge, well studied before. Furthermore, we found no report comparing serologic response to the influenza vaccine antigens between CAD patients and healthy controls.
This study aims to identify the efficacy of influenza vaccination in CAD individuals in terms of both serologic response (as compared with healthy individuals) and clinical outcomes (as compared with CAD patients not vaccinated).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| CAD-Exp | Experimental | Enrolled coronary artery disease patients who are randomly assigned to receive influenza vaccine |
|
| CAD-Control | Placebo Comparator | Enrolled coronary artery disease patients who are randomly assigned to receive placebo of influenza vaccine |
|
| Healthy-Control | Experimental | Enrolled healthy subjects serve as control for CAD-Exp |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| influenza vaccine | Biological | Intramuscular injection of one 0.5-mL dose of influenza vaccine |
|
| Measure | Description | Time Frame |
|---|---|---|
| Influenza infection | 6 months | |
| Serologic response (≥4-fold HI titer rise) to each of the 3 antigens of the trivalent vaccine of the 2006-07 campaign [Solomon Islands/3/2006(H1N1), Wisconsin/67/2005 (H3N2), and Malaysia/2506/2004 - like strains] | 1 month |
| Measure | Description | Time Frame |
|---|---|---|
| Magnitude of change in the antibody titer against each of the three influenza vaccine antigens | 1 month | |
| Protective antibody (≥1:40) titer after vaccination | 1 month | |
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Inclusion Criteria:
Coronary artery disease (CAD) group (CAD-Exp and CAD-Control):
Patients with the diagnosis of acute, evolving or recent MI (after recovered the acute phase) as defined by:
1. Typical rise and gradual fall (troponin) or more rapid rise and fall (CK-MB) of biochemical markers of myocardial necrosis with at least one of the following:
Ischemic symptoms
Development of pathologic Qwaves on the ECG
ECG changes indicative of ischemia (ST segment elevation or depression); OR
Coronary artery intervention (e.g., coronary angioplasty). 2. Pathologic findings of an acute MI [1]:
Patients with stable angina pectoris (SA) and documented coronary artery stenosis (angiography).
Healthy Control group: healthy controls, proportionally matched by gender and age with the patient group (separate control groups for MI and SA patients).
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Maryam Keshtkar-Jahromi, M.D.; M.P.H. | Infectious Diseases and Tropical Medicine Research Center, Shaheed Beheshti Medical University, Tehran, Iran | Study Chair |
| Hossein Vakili, M.D. | Cardiovascular Research Center, Shaheed Beheshti Medical University, Tehran, Iran | Principal Investigator |
| Mohammad Rahnavardi, M.D. | Infectious Diseases and Tropical Medicine Research Center, Shaheed Beheshti Medical University, Tehran, Iran | Principal Investigator |
| Ali Eskandari, MD | Shaheed Beheshti University (MC) | Principal Investigator |
| Sharareh Gholamin, MD | Shaheed Beheshti University (MC) | Principal Investigator |
| Seyed Mostafa Razavi, MD | Shaheed Beheshti University (MC) | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Shaheed Modarres Medical Center | Tehran | Tehran Province | Iran |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 15367555 | Background | Thompson WW, Shay DK, Weintraub E, Brammer L, Bridges CB, Cox NJ, Fukuda K. Influenza-associated hospitalizations in the United States. JAMA. 2004 Sep 15;292(11):1333-40. doi: 10.1001/jama.292.11.1333. | |
| 16702489 | Background | Smith SC Jr, Allen J, Blair SN, Bonow RO, Brass LM, Fonarow GC, Grundy SM, Hiratzka L, Jones D, Krumholz HM, Mosca L, Pasternak RC, Pearson T, Pfeffer MA, Taubert KA; AHA/ACC; National Heart, Lung, and Blood Institute. AHA/ACC guidelines for secondary prevention for patients with coronary and other atherosclerotic vascular disease: 2006 update: endorsed by the National Heart, Lung, and Blood Institute. Circulation. 2006 May 16;113(19):2363-72. doi: 10.1161/CIRCULATIONAHA.106.174516. No abstract available. |
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| ID | Term |
|---|---|
| D003324 | Coronary Artery Disease |
| D009203 | Myocardial Infarction |
| D060050 | Angina, Stable |
| D007251 | Influenza, Human |
| ID | Term |
|---|---|
| D003327 | Coronary Disease |
| D017202 | Myocardial Ischemia |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
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| ID | Term |
|---|---|
| D007252 | Influenza Vaccines |
| ID | Term |
|---|---|
| D014765 | Viral Vaccines |
| D014612 | Vaccines |
| D001688 | Biological Products |
| D045424 | Complex Mixtures |
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| placebo for influenza vaccine | Biological | Intramuscular injection of one 0.5-mL dose of placebo for influenza vaccine |
|
| influenza vaccine | Biological | Intramuscular injection of one 0.5-mL dose of influenza vaccine |
|
|
| Influenza-related death |
| 6 months |
| 11994246 | Background | Gurfinkel EP, de la Fuente RL, Mendiz O, Mautner B. Influenza vaccine pilot study in acute coronary syndromes and planned percutaneous coronary interventions: the FLU Vaccination Acute Coronary Syndromes (FLUVACS) Study. Circulation. 2002 May 7;105(18):2143-7. doi: 10.1161/01.cir.0000016182.85461.f4. |
| 14563288 | Background | Leon de la Fuente R, Gurfinkel EP, Toledo D, Mautner B; Grupo de Estudio FLUVACS. [Flu vaccination in patients with acute coronary syndromes: treatment benefit in prespecified subgroups]. Rev Esp Cardiol. 2003 Oct;56(10):949-54. doi: 10.1016/s0300-8932(03)76991-7. Spanish. |
| 12244032 | Background | Jackson LA, Yu O, Heckbert SR, Psaty BM, Malais D, Barlow WE, Thompson WW; Vaccine Safety Datalink Study Group. Influenza vaccination is not associated with a reduction in the risk of recurrent coronary events. Am J Epidemiol. 2002 Oct 1;156(7):634-40. doi: 10.1093/aje/kwf073. |
| 10987628 | Background | Alpert JS, Thygesen K, Antman E, Bassand JP. Myocardial infarction redefined--a consensus document of The Joint European Society of Cardiology/American College of Cardiology Committee for the redefinition of myocardial infarction. J Am Coll Cardiol. 2000 Sep;36(3):959-69. doi: 10.1016/s0735-1097(00)00804-4. |
| D001161 |
| Arteriosclerosis |
| D001157 | Arterial Occlusive Diseases |
| D014652 | Vascular Diseases |
| D007238 | Infarction |
| D007511 | Ischemia |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D009336 | Necrosis |
| D000787 | Angina Pectoris |
| D002637 | Chest Pain |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D012141 | Respiratory Tract Infections |
| D007239 | Infections |
| D009976 | Orthomyxoviridae Infections |
| D012327 | RNA Virus Infections |
| D014777 | Virus Diseases |
| D012140 | Respiratory Tract Diseases |