Vaccination should be considered as one of the pillars of cardiovascular prevention of patients with chronic pathologies, alongside other measures such as statins or intervention on lifestyle, according to a consensus published by the European Cardiology Society (ESC) in the European Heart Journal. “It has now been years that we know that flu has increased the risk of cardiovascular incident such as myocardial infarction”, says Professor Thomas Lüscher, current president of the ESC and principal author.
In their article, specialists describe the available data concerning the risk of cardiovascular complications associated with pneumococcal infection, flu, SARS-COV-2 and syncytial respiratory virus (VRS). They also explain the mechanisms involved: pro-inflammatory signaling routes, destabilization of coronary plates, the increase in myocardial oxygen needs and the risk of consecutive ischemia. In addition, viruses Influenza can directly infect the coronary endothelium and disturb its metabolism. Studies have also shown that the H3N2 flu virus can persist in atherosclerosis plates and myocardium up to several weeks after infection.
The flu increases hospitalizations in the event of heart disease
According to a cohort study conducted in the United States in 2024, around 3 % of deaths and 5 % of hospitalizations for influenza or pneumonia affect patients with heart-based patients each year. In addition, an analysis of the atherosclerotic risk database in communities (ARIC) showed that an increase of 5 % of influenza activity in the general population is associated with a 24 % increase in hospitalizations in the population with chronic heart disease.
According to the results of the Polish study Flucad and an American meta analysis, vaccination against flu decreases the risk of major cardiovascular accident by 30 %. The use of higher doses of antigripping vaccine could protect more effectively from cardiovascular events, according to preliminary data. Several tests in progress seek to verify it.
Covid and pneumococci also concerned
In addition, patients with cardiovascular pathologies have an increased risk of developing a serious or prolonged form of Covid. It is estimated that vaccination reduces this risk by 43 %. Vaccination against invasive pneumococcal infections reduces 10 % the risk of cardiovascular incident according to a Canadian meta analysis of 2020.
The article also includes practical advisor recommendations from ESC, American college of cardiology and American Heart Association (AHA), which offer to systematically vaccinate all people with chronic coronary syndrome or heart failure. The ESC issues a class IA recommendation (same level as for statins) to seasonal vaccination against flu and estimates that the strategies already implemented to vaccinate people at risk are still largely insufficient.
