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

• Published in: BMC public health 2012-03, Vol.12 (1), p.222-222, Article 222
• Main Authors: Vila-Corcoles, Angel, Ochoa-Gondar, Olga, Rodriguez-Blanco, Teresa, Gutierrez-Perez, Antonia, Vila-Rovira, Angel, Gomez, Frederic, Raga, Xavier, de Diego, Cinta, Satue, Eva, Salsench, Elisabet
• Format: Article
• Language: English
• Subjects: Acute Disease; Aged; Brain Ischemia - epidemiology; Brain Ischemia - prevention & control; Cohort Studies; Community-Acquired Infections - epidemiology; Community-Acquired Infections - prevention & control; Female; Follow-Up Studies; Health aspects; Heart attack; Heart attacks; Hospitalization - statistics & numerical data; Humans; Immunization; Male; Medical Records Systems, Computerized; Myocardial Infarction - diagnosis; Myocardial Infarction - epidemiology; Myocardial Infarction - prevention & control; Pneumococcal vaccine; Pneumococcal Vaccines - administration & dosage; Pneumonia; Pneumonia - epidemiology; Pneumonia - prevention & control; Pneumonia, Pneumococcal - epidemiology; Pneumonia, Pneumococcal - prevention & control; Population Surveillance; Prevention; Prospective Studies; Spain; Streptococcus pneumoniae; Stroke (Disease); Studies; Treatment Outcome; Vaccination - statistics & numerical data; Vaccines
• ISSN: 1471-2458; 1471-2458
• DOI: 10.1186/1471-2458-12-222

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. 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). 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). 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.