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Posted: November 11, 2008

Shot to Prevent Pneumonia May Also Cut Heart Attack Risk: Study

Vaccination against a common type of bacterial pneumonia appears to have a dramatically lower risk of heart attack than those who have not been vaccinated, research scientists say.


The finding derives from a study by a Canadian research team of about 5,000 patients who were identified as being at-risk for a heart attack.


The investigators said their discovery raises intriguing questions about the role of infection and inflammation on the cardiovascular system and offers another possible reason for getting vaccinated against pneumococcal pneumonia.


"We know that the pneumococcal vaccination can alter one of the complex mechanisms of atherosclerosis, one of the steps in the formation of atherosclerotic plaque," said principal investigator Dr. Danielle Pilon of the University of Sherbrooke in Quebec. "So we wanted to see if this could be replicated in clinic."


"The hypothesis was that if the vaccination can alter one of the steps in atherosclerosis formation, perhaps it could decrease the risk of heart attack. And this is what we found."


With atherosclerosis, plaque – comprised of fat, cholesterol, calcium and other substances in the blood -- builds up on the artery walls. Over time, plaque thickens, hardens and eventually clogs the arteries, which can lead to potentially fatal heart attacks or stroke.


In a report on the findings published in the Canadian Medical Association Journal, Pilon said vaccination was associated with a more than 50% reduction in the rate of heart attack following the pneumonia inoculation.


"We didn't expect that much really," said Pilon, a specialist in internal medicine and clinical pharmacology. "For our results, the effect of the vaccine was more evident after a year, but probably it could be more after two or three or five years."


However, she cautioned about over-interpreting the results of the research, which compared about 1,000 patients who had suffered a heart attack with about 4,000 patients who had not had a heart attack, but were at high risk for one. Subjects had a mean age of about 60.


"This is a case-controlled study, so we have to be very careful,” she said, adding: “It is still an explanatory study and the results are still to be confirmed.”


Previous research has shown that pneumococcal pneumonia and other respiratory infections, including influenza and SARS, have been found to trigger a heart attack in some patients. "In fact, during almost all influenza epidemics and pandemics (except the 1918 Spanish flu pandemic), about twice as many people die of cardiac causes as die of pneumonia," Dr. Mohammad Madjid, of the Texas Heart Institute in Houston, wrote in a commentary accompanying the study’s publication.


Pneumococcal vaccine is recommended by the U.S. Centers for Disease Control and Prevention for everybody aged 65 and older and for persons with chronic ailments such as heart disease. The government goal is to have 90 percent of the over-65 population get the vaccine, but the actual rate "is much less than it should be," Madjid said.

Madjid said that until confirming studies are available on Pilon’s team findings, doctors should comply with current medical guidelines by increasing vaccination rates among patients at high risk of heart attack and stroke, while at the same time treating them with appropriate medications.

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