Global, regional and national estimates of influenza-attributable ischemic heart disease mortality.

Background

Influenza virus infection is associated with incident ischemic heart disease (IHD) events. Here, we estimate the global, regional, and national IHD mortality burden attributable to influenza.

Methods

We used vital registration data from deaths in adults ≥50 years (13.2 million IHD deaths as underlying cause) to assess the relationship between influenza activity and IHD mortality in a non-linear meta-regression framework from 2010 to 2019. This derived relationship was then used to estimate the global influenza attributable IHD mortality. We estimated the population attributable fraction (PAF) of influenza for IHD deaths based on the relative risk associated with a given level of weekly influenza test positivity rate and multiplied PAFs by IHD mortality from the Global Burden of Disease study.

Findings

Influenza activity was associated with increased risk of IHD mortality across all countries analyzed. The mean PAF of influenza for IHD mortality was 3.9% (95% uncertainty interval [UI] 2.5-5.3%), ranging from <1% to 10%, depending on country and year. Globally, 299,858 IHD deaths (95% UI 191,216-406,809) in adults ≥50 years could be attributed to influenza, with the highest rates per 100,000 population in the Central Europe, Eastern Europe and Central Asia Region (32.3; 95% UI 20.6-43.8), and in the North Africa and Middle East Region (26.7; 95% UI 17-36.2).

Interpretation

Influenza may contribute substantially to the burden of IHD. Our results suggest that if there were no influenza, an average of 4% of IHD deaths globally would not occur.

Funding

Collaborative study funded by Sanofi Vaccines.

Informations de copyright

© 2022 The Author(s).

Déclaration de conflit d'intérêts

J.R.O. reports that he has received fees from IHME for consulting on the submitted work; honoraria from Moderna, Pfizer, and Seqirus to serve on scientific advisory boards; fees for serving on a DSMB and as an independent safety monitor for Pharmaron; and his institution has received research funding from Bill & Melinda Gates Foundation, NIH, Pfizer, and the World Health Organization. J.N. worked for Sanofi during the study analysis and may own stocks. S.S.C. and C.M. work for Sanofi. T.B.-S. reports steering committee member of the Amgen financed GALACTIC-HF trial, the Boston Scientific “LUX-Dx TRENDS Evaluates Diagnostics Sensors in Heart Failure Patients Receiving Boston Scientific's Investigational ICM System” trial. Chief investigator and steering committee chair of the Sanofi Pasteur financed “NUDGE-FLU” trial, “DANFLU-1” trial and the Sanofi Pasteur financed “DANFLU-2” trial. Advisory Board: Sanofi Pasteur, Amgen and GSK. Speaker Honorarium: Novartis, Sanofi Pasteur and GSK. Research grants: GE Healthcare and Sanofi Pasteur. D.M. reported that his institution has received a grant from Sanofi Pasteur unrelated to this study. M.B. reported that his institution had a contract to Sanofi for the current study.