TY - JOUR
T1 - Influenza Vaccination and Risk of Stroke in Women With Chronic Obstructive Pulmonary Disease
T2 - A Nationwide, Population-Based, Propensity-Matched Cohort Study
AU - Chen, Chun Chao
AU - Lin, Cheng Hsin
AU - Chiu, Chun Chih
AU - Yang, Tsung Yeh
AU - Hsu, Min Huei
AU - Wang, Yuan Hung
AU - Lei, Meng Huan
AU - Yeh, Hsien Tang
AU - Fang, Yu Ann
AU - Hao, Wen Rui
AU - Liu, Ju Chi
N1 - Funding Information:
This work was financially supported of the Higher Education Sprout Project by the Ministry of Education (MOE) in Taiwan, and granted by the Taiwan Ministry of Health and Welfare (MOHW109-TDU-B-212-114007 and MOHW110-TDU-B-212-124007), and 109FRP-07 from the Taipei Medical University-Shuang Ho Hospital, Ministry of Health and Welfare.
Publisher Copyright:
Copyright © 2022 Chen, Lin, Chiu, Yang, Hsu, Wang, Lei, Yeh, Fang, Hao and Liu.
PY - 2022/5/19
Y1 - 2022/5/19
N2 - Backgrounds: The risk of stroke is higher among patients with chronic obstructive pulmonary disease (COPD) than among the healthy population. Moreover, women generally have worse long-term stroke outcomes than men. Methods: The data of 6681 women with COPD (aged ≥ 65 years) registered in Taiwan’s National Health Insurance Research Database were retrospectively analyzed from January 1, 2001 to December 31, 2011. After 1:1 propensity score matching, the patients were divided into vaccinated and unvaccinated groups. Results: In total, 5102 women were enrolled. The vaccinated group had a significantly lower risk of total, hemorrhagic, and ischemic stroke than the unvaccinated group (adjusted hazard ratio [aHR]: 0.60, 95% confidence interval [CI]: 0.54–0.67; aHR: 0.59, 95% CI: 0.43–0.83; and aHR: 0.59, 95% CI: 0.52–0.68, respectively). A lower risk of stroke was observed among the women aged 65–74 and ≥75 years, and the association was dose-dependent in all types of stroke (aHR: 1.08, 95% CI: 0.92–1.26; aHR: 0.70, 95% CI: 0.60–0.82; and aHR: 0.32, 95% CI: 0.26–0.38 for those vaccinated 1, 2 to 3, and ≥4 times, respectively, during the follow-up period). Women with a CHA2DS2-VASc score (conditions and characteristics included congestive heart failure, hypertension, diabetes, stroke, vascular disease, age, and sex) of 2–3 and ≥4 had a significantly lower risk of ischemic stroke while receiving more vaccinations. A smaller significant lower risk of hemorrhagic stroke after more than 4 times of vaccination was noted in the women with a CHA2DS2-VASc score of ≥4. Both interrupted and non-interrupted vaccination was associated with lower risk of stroke occurrence. Conclusion: Influenza vaccination is associated with a lower risk of total, hemorrhagic, and ischemic stroke among women with COPD, and the association is dose-dependent. However, the findings may be limited by unmeasurable confounders. Further investigations on this subject are warranted.
AB - Backgrounds: The risk of stroke is higher among patients with chronic obstructive pulmonary disease (COPD) than among the healthy population. Moreover, women generally have worse long-term stroke outcomes than men. Methods: The data of 6681 women with COPD (aged ≥ 65 years) registered in Taiwan’s National Health Insurance Research Database were retrospectively analyzed from January 1, 2001 to December 31, 2011. After 1:1 propensity score matching, the patients were divided into vaccinated and unvaccinated groups. Results: In total, 5102 women were enrolled. The vaccinated group had a significantly lower risk of total, hemorrhagic, and ischemic stroke than the unvaccinated group (adjusted hazard ratio [aHR]: 0.60, 95% confidence interval [CI]: 0.54–0.67; aHR: 0.59, 95% CI: 0.43–0.83; and aHR: 0.59, 95% CI: 0.52–0.68, respectively). A lower risk of stroke was observed among the women aged 65–74 and ≥75 years, and the association was dose-dependent in all types of stroke (aHR: 1.08, 95% CI: 0.92–1.26; aHR: 0.70, 95% CI: 0.60–0.82; and aHR: 0.32, 95% CI: 0.26–0.38 for those vaccinated 1, 2 to 3, and ≥4 times, respectively, during the follow-up period). Women with a CHA2DS2-VASc score (conditions and characteristics included congestive heart failure, hypertension, diabetes, stroke, vascular disease, age, and sex) of 2–3 and ≥4 had a significantly lower risk of ischemic stroke while receiving more vaccinations. A smaller significant lower risk of hemorrhagic stroke after more than 4 times of vaccination was noted in the women with a CHA2DS2-VASc score of ≥4. Both interrupted and non-interrupted vaccination was associated with lower risk of stroke occurrence. Conclusion: Influenza vaccination is associated with a lower risk of total, hemorrhagic, and ischemic stroke among women with COPD, and the association is dose-dependent. However, the findings may be limited by unmeasurable confounders. Further investigations on this subject are warranted.
KW - COPD
KW - hemorrhagic stroke
KW - influenza vaccination
KW - ischemic stroke
KW - women
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U2 - 10.3389/fmed.2022.811021
DO - 10.3389/fmed.2022.811021
M3 - Article
AN - SCOPUS:85131766277
SN - 2296-858X
VL - 9
JO - Frontiers in Medicine
JF - Frontiers in Medicine
M1 - 811021
ER -
