RT Journal Article
SR Electronic
T1 Pneumococcal vaccination and risk of myocardial infarction
JF Canadian Medical Association Journal
JO CMAJ
FD Canadian Medical Association
SP 773
OP 777
DO 10.1503/cmaj.070221
VO 179
IS 8
A1 François Lamontagne, MD MSc
A1 Marie-Pierre Garant, PhD
A1 Jean-Christophe Carvalho MD
A1 Luc Lanthier, MD MSc
A1 Marek Smieja, MD PhD
A1 Danielle Pilon, MD MSc
YR 2008
UL http://www.cmaj.ca/content/179/8/773.abstract
AB Background: Based on promising results from laboratory studies, we hypothesized that pneumococcal vaccination would protect patients from myocardial infarction. Methods: We conducted a hospital-based case–control study that included patients considered to be at risk of myocardial infarction. We used health databases to obtain hospital diagnoses and vaccination status. We compared patients who had been admitted for treatment of myocardial infarction with patients admitted to a surgical department in the same hospital for a reason other than myocardial infarction between 1997 and 2003. Results: We found a total of 43 209 patients who were at risk; of these, we matched 999 cases and 3996 controls according to age, sex and year of hospital admission. Cases were less likely than controls to have been vaccinated (adjusted odds ratio [OR] 0.53, 95% confidence interval [CI] 0.40–0.70). This putative protective role of the vaccine was not observed for patients who had received the vaccine up to 1 year before myocardial infarction (adjusted OR 0.85, 95% CI 0.54–1.33). In contrast, if vaccination had occurred 2 years or more before the hospital admission, the association was stronger (adjusted OR 0.33, 95% CI 0.20–0.46). Interpretation: Pneumococcal vaccination was associated with a decrease of more than 50% in the rate myocardial infarction 2 years after exposure. If confirmed, this association should generate interest in exploring the putative mechanisms and may offer another reason to promote pneumococcal vaccination.