Review ArticleRole of Influenza Vaccination in Cardiovascular Disease: Systematic Review and Meta-AnalysisGupta, Rahul MD*; Quy, Ray BS†; Lin, Muling BS†; Mahajan, Pranav MD*; Malik, Aaqib MD, MPH‡; Sood, Aayushi MD§; Sreenivasan, Jayakumar MD, MSc¶; Bandyopadhyay, Dhrubajyoti MD‡; Goel, Akshay MD‡; Agrawal, Ankit MDǁ; Vyas, Apurva V. MD, FACC*; Patel, Nainesh C. MD, FACC, FSCAI*; Frishman, William H. MD‡,**; Aronow, Wilbert S. MD, FACC‡,** Author Information From the *Lehigh Valley Heart Institute, Lehigh Valley Health Network, Allentown, PA †Department of Internal Medicine, University of South Florida, Morsani College of Medicine, Tampa, FL ‡Department of Cardiology, Westchester Medical Center, Valhalla, NY §Department of Medicine, Wright Center for Graduate Medical Education, Scranton, PA ¶Department of Cardiovascular Medicine, Yale University School of Medicine, New Haven, CT ǁDepartment of Hospital Medicine, Cleveland Clinic, Cleveland, OH **Department of Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY. Disclosure: The authors have no conflicts of interest to report. An abstract was accepted for poster presentation at the American College of Cardiology conference 2022. All authors have read and approved the manuscript; All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation. Correspondence: Rahul Gupta, MD, Lehigh Valley Heart Institute, Lehigh Valley Health Network, Allentown, PA. E-mail: [email protected]. Cardiology in Review ():10.1097/CRD.0000000000000533, May 04, 2023. | DOI: 10.1097/CRD.0000000000000533 Buy PAP Metrics Abstract Influenza vaccination has shown great promise in terms of its cardioprotective effects. The aim of our analysis is to provide evidence regarding the protective effects of influenza vaccination in patients with cardiovascular disease. We conducted a systematic literature search to identify trials assessing the cardiovascular outcomes of influenza vaccination. Summary effects were calculated using a DerSimonian and Laird fixed effects and random effects model as odds ratio with 95% confidence intervals (CIs) for all the clinical endpoints. Fifteen studies with a total of 745,001 patients were included in our analysis. There was lower rates of all-cause mortality [odds ratio (OR) = 0.74, 95% CI 0.64–0.86], cardiovascular death (OR = 0.73, 95% CI 0.59–0.92), and stroke (OR = 0.71, 95% CI 0.57–0.89) in patients who received the influenza vaccine compared to placebo. There was no significant statistical difference in rates of myocardial infarction (OR = 0.91, 95% CI 0.69–1.21) or heart failure hospitalizations (OR = 1.06, 95% CI 0.85–1.31) in the 2 cohorts. In patients with cardiovascular disease, influenza vaccination is associated with lower all-cause mortality, cardiovascular death, and stroke. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.