News for week ending 17 May 2002

FLU SHOT CUTS HEART ATTACKS

The humble flu vaccine is showing promising signs of reducing the risk of death and chest pains in people suffering from a heart attack and those recovering from angioplasty during the flu season.

In a six-month study, Argentinean researchers led by Enrique Gurfinkel found a significant impact on the incidence of cardiovascular death in vaccinated patients. It is thought the vaccine can modulate a key element in atherosclerosis, namely the immune system.

Results, of what is thought to be the first study to test the use prophylactic influenza vaccine during the acute phase of coronary artery disease and during planned angioplasty, were announced this week at the 14th World Congress of Cardiology in Sydney.

Dr Gurfinkel says the finding has important implications for the future with regard to vaccines replacing drug treatments. There is already a small study in progress investigating the effect of vaccines on strokes.

"Initial observation shows fewer strokes," he says. Dr Gurfinkel says the team began to investigate the effect of the flu jab on myocardial infarction (MI) for a number of reasons. These include the fact that statistics show there are a larger number of coronary deaths during the winter season, antibiotics have been shown to reduce coronary syndromes, and a number of viruses are thought to be involved in both MI and subsequent events.

Some viruses are known to upset normal cholesterol metabolism leading to cholesterol accumulation. They can also increase smooth cell uptake of LDL (bad cholesterol). Linking infections to atherosclerosis has proved difficult, but viral infections could reduce the immune response to chlamydia infection that has been investigated in relation to plaque rupture in arteries (leading to cardiovascular events) and atherosclerosis.

Of the total of 305 patients recruited, 301 were assigned to either vaccine therapy or control. Cardiovascular death occurred in 2 per cent of the patients in the vaccine group compared with 8 per cent in the control group. A combination of cardiovascular death, non-fatal myocardial infarction (heart attack) or severe ischemia occurred in 11 per cent of patients in the vaccine group versus 23 per cent in the controls.

No patient was lost during the follow up at 180 days. Dr Gurfinkel, from the Favalora Foundation in Buenos Aires, Argentina, is notable for two other world firsts, discovering the role of low molecular weight heparins and using antibiotics in the prevention of coronary syndromes (Lancet, 1997).

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