The clinical impact of the influenza vaccination on cardiovascular outcomes in people with established cardiovascular disease (CVD) is still debated. The aim of this meta-analysis was to estimate the effect of influenza vaccination on cardiovascular and cerebrovascular outcomes among patients with established CVD. We systematically searched all electronic databases from inception until 15 April 2022. Primary clinical outcomes were all-cause mortality (ACM), and major adverse clinical events (MACE). Secondary endpoints were heart failure, myocardial infarction, CV mortality, and stroke. Eighteen articles (five randomized trials and thirteen observational studies), with a total of 22,532,165 patients were included in the analysis. There were 217,072 participants included in the high cardiovascular risk or established CVD population (vaccinated n = 111,073 and unvaccinated n = 105,999). The mean age of the patients was 68 years old, without any difference between groups (69 vs 71) years. At mean follow-up of 1.5 years, vaccinated group was associated with lower risk for all-cause mortality [HR, 0.71(95%CI, 0.63-0.80), p < 0.001], MACE [HR, 0.83(95%CI:0.72-0.96), p = 0.01], CV mortality [HR, 0.78(95%CI:0.68-0.90), p < 0.001] and myocardial infarction [HR, 0.82(95%CI:0.74-0.92), p < 0.001] compared to unvaccinated group. While incidence of stroke [HR, 1.03 (95%CI, 0.92-1.06), p = 0.61] and heart failure [HR, 0.74 (95%CI, 0.51-1.08), p = 0.12] did not differ between the two groups. Influenza vaccination reduced major adverse clinical events, all-cause mortality, CV mortality and myocardial infarction. These highlighted the importance of influenza vaccination in established CVD or high cardiovascular risk. Cardioprotective effect of Influenza vaccine among patients with established cardiovascular disease or at high rish with a significant reduction in mortality and adverse cardiovascular outcomes.

Various studies have suggested the possible cardiovascular (CV) protective effects of the pneumococcal vaccine (PV). Therefore, we conducted a meta-analysis to assess the association between recipients of PV with mortality and CV outcomes among patients with and without established cardiovascular disease. We performed a systematic literature search in PubMed, Embase, and Scopus for studies evaluating the effect of PV on mortality and CV outcomes. A total of 15 studies with 347,444 patients were included in the meta-analysis: 111,784 patients received PV (32%) and 235,660 patients were in the unvaccinated group (68%). Recipients of PV were associated with decreased all-cause mortality (HR, 0.76 (95% CI: 0.66 to 0.87), p < 0.001). PV was associated with a decrease in the incidence of myocardial infarction (MI) (HR, 0.73 (95% CI: 0.56–0.96), p = 0.02), without significant reduction in CV mortality (HR, 0.87 (95% CI: 0.72–1.07), p = 0.18) and stroke (HR, 1.01 (95% CI: 0.93–1.10), p = 0.82). Our study found PV was associated with decreased risk of all-cause mortality and MI. Future RCTs will be necessary to confirm benefits associated with receipt of PV.

Background: Sodium-glucose co-transporter 2 (SGLT2) inhibitors have been recommended in the practice guidelines for the treatment of patients with heart failure with reduced ejection fraction; however, their effects among patients with preserved ejection fraction have been debatable. Objective: We aim to evaluate the SGLT2 inhibitor effect among patients with heart failure with reduced ejection fraction, including DELIVER and EMPEROR-Preserved trials. Methods: We performed a systematic literature search using the PubMed, Embase, Scopus, and Cochrane libraries for relevant articles from inception until August 30th, 2022. Statistical analysis was performed by calculating hazard ratio (HR) using the random effect model with a 95% confidence interval (CI) and probability value (P). Statistical significance was met if 95% CI does not cross numeric “1” and P < .05. Results: Six studies with a total of 15,989 total patients were included in the final analysis. The mean age of patients enrolled in SGLT2 inhibitors and placebo was 69.13 and 69.37 years, respectively. The median follow-up duration was 2.24 years. SGLT2 inhibitors reduced composite cardiovascular mortality or first hospitalization for heart failure (HR, 0.80 [95% CI: 0.74–0.87], P < .001, I ² = 0%), heart failure hospitalization (HR, 0.74 [95% CI: 0.67–0.82], P < .001, I ² = 0%) compared with placebo. However, all-cause mortality (HR, 0.97 [95% CI: 0.89–1.06], P = .54, I ² = 0%) and cardiovascular mortality (HR, 0.96 [95% CI: 0.82–1.13), P = .66, I ² = 35.09%] were comparable between both groups. Conclusion: Our study finding shows that SGLT2 inhibitors significantly reduced the risk of first HF hospitalization or cardiovascular death and HF hospitalization; however, all-cause mortality was comparable between the groups.

Background: The Amplatzer Amulet (AA) and Watchman devices (WD) are the 2 most frequently used devices for percutaneous LAA closure globally. Objective: To evaluate the safety and clinical outcomes associated with these 2 devices in patients undergoing percutaneous LAA closure. Method: We systematically searched all electronic databases from inception until February 21, 2023. The primary endpoint was procedure related complications. Secondary endpoints were device related thrombus, stroke, cardiovascular mortality, peri device leak, systemic embolism, and all-cause mortality. Results: A total of 3 randomized clinical trials with 2150 patients were included in this meta-analysis. The mean age was 75 and 76 years in the Amplatzer group and in the Watchman group, respectively. The odds of procedure-related complications (OR, 1.80 [95% CI: 1.21–2.67], P < .001) were significantly higher among patients with AA compared to the WD. However, the odds of all-cause mortality (OR, 0.75 (95% CI: 0.49–1.16), P = .20), stroke (OR, 0.79 [95% CI: 0.47–1.34], P = .39), systemic/pulmonary embolism (OR, 1.34 [95% CI: 0.30–6.04], P = .70), and major bleeding (OR, 1.10 [95% CI: 0.83–1.48], P = .50) were comparable between the two devices. The odds of device related thrombus (OR, 0.72 [95% CI: 0.46–1.14], P = .17) was comparable between both the group of patients, however the incidence of peri device leak was significantly lower in AA group (OR, 0.41 [95% CI: 0.26–0.66], P < .001) compared with WD group of patients. Conclusion: The AA was not superior to the Watchman device in terms of safety and efficacy. However, the Amulet occluder was associated with a higher incidence of procedure-related complications, and lower peri device leak.

Sarcoidosis is a chronic inflammatory disorder of unknown etiology associated with high morbidity and mortality. Its association with cardiovascular outcomes is under-documented. The aim of this study was to assess the adverse cardiovascular outcomes in patients with sarcoidosis compared with that of non-sarcoidosis. Online databases including PubMed, Embase and Scopus were queried from inception until March 2022. The outcomes assessed included all-cause mortality (ACM) and incidence of ventricular tachycardia (VT), heart failure (HF) and atrial arrhythmias (AA). A total of 6 studies with 22,539,096 participants (42,763 Sarcoidosis, 22,496,354 Non-Sarcoidosis) were included in this analysis. The pooled prevalence of sarcoidosis was 13.1% (95% CI 1% to 70%). The overall mean age was 47 years. The most common comorbidities were hypertension (12.7% vs 12.5%), and diabetes mellitus (5.5% vs 4%) respectively. The pooled analysis of primary endpoints showed that all-cause mortality (RR, 2.08; 95% CI: 1.17 to 3.08; p = 0.01) was significantly increased in sarcoidosis patients. The pooled analysis of secondary endpoints showed that the incidence of VT (RR, 15.3; 95% CI: 5.39 to 43.42); p < 0.001), HF (RR, 4.96; 95% CI: 2.02 to 12.14; p < 0.001) and AA (RR, 2.55; 95% CI: 1.47 to 4.44); p = 0.01) were significantly higher with sarcoidosis respectively compared to non-sarcoidosis. Incidence of VT, HF and AA was significantly higher in patients with CS. Clinicians should be aware of these adverse cardiovascular events associated with sarcoidosis.

Background: Leadless pacemakers offer a safe and effective alternative pacing strategy. However, limited data are available for patients with end stage renal disease (ESRD), a population of significant relevance. Methods: Using the Nationwide Readmission Database, we extracted data from all adult patients with ESRD who underwent traditional transvenous or leadless pacemaker implantation between 2016 and 2021. We compared in-hospital mortality, 30-day readmission rates, complication rates, and healthcare resource utilization between the two cohorts. Results: A total of 6384 (81.2%) patients were included in the transvenous pacemaker cohort, and 1481(18.8%) patients were included in the leadless pacemaker cohort. In patients with ESRD, leadless pacemaker implantation was linked to higher in-hospital complications when compared to transvenous pacemakers. These included the need for blood transfusion (aOR 1.85, 95% CI 1.32–2.60, p < 0.01), vascular complications (aOR 3.6, CI 1.40–9.26, p = 0.01), and cardiac complications (aOR 4.12, CI 1.70–9.98, p < 0.01). However, there were no differences between the two groups in terms of in-hospital mortality and 30-day readmission rates. The median length of stay was longer for leadless pacemaker implantation than transvenous pacemaker implantation (5 days vs. 4 days, p < 0.01). The total hospitalization charges were also higher ($139,826 vs. $93,919, p < 0.01). Conclusions: Although previous studies have demonstrated lower long-term complication rates with leadless pacemakers than transvenous pacemakers, our analysis shows a higher risk of short-term in-hospital complications in ESRD patients, though no differences in in-hospital mortality and 30-day readmissions.