Prognostic Indicators for Heart Failure Hospitalization in Acute Coronary Syndrome Patients: An Observational Study under the In(cid:976)luenza Vaccination Trial
Apirak Sribhutorn BPharm, MPharm1,2, Arintaya Phrommintikul MD3, Wanwarang Wongcharoen MD3, Usa Chaikledkaew BSc in Pharm, MA, PhD4, Suntara Eakanunkul BPharm, PhD5, Jayanton Patumanond MD, MSc, DSc6, Apichard Sukonthasarn MD3
Affiliation : 1 PhD Program in Clinical Epidemiology, Faculty of Medicine, Chiang Mai University, Thailand 2 Department of Pharmacy Practice, School of Pharmaceutical Sciences, University of Phayao, Phayao, Thailand 3 Cardiology Division, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Thailand
4 Social and Administrative Pharmacy Excellence Research (SAPER) Unit, Department of Pharmacy, Faculty of Pharmacy,
Mahidol University, Bangkok, Thailand
5 Department of Pharmaceutical Sciences, Faculty of Pharmacy, Chiang Mai University, Thailand
6 Department of Clinical Epidemiology and Clinical Statistics, Clinical Research Center, Faculty of Medicine, Thammasat University,
Pathum Thani, Thailand
Background : Heart failure [HF] is described as a consequence from tissue injury in myocardial infarction through (cid:976)inally organ
failure. Therefore, HF prevention through forecasting clinical predictors is useful for closely HF monitoring and management.
Objective : To explore prognostic indicators for HF hospitalization in Acute coronary syndrome [ACS] patients through the in(cid:976)luenza
vaccination trial.
Materials and Methods : These observational data were collected from 439 ACS patients of Phrommintikul et al. The inactivated
in(cid:976)luenza vaccine was injected intramuscularly as a single dose in the vaccination group. The HF hospitalization outcome was
determined through one-year follow-up time. The multivariable Cox’s regression model was performed to explore the prognostic
values.
Results : The signi(cid:976)icant prognostic indicators were female (HR 4.05, 95% CI 1.25 to 13.19, p = 0.020), dyslipidemia (HR 7.44, 95%
CI 1.88 to 29.40, p = 0.004), elevated SCr (HR = 5.46, 95% CI 1.39 to 21.41, p = 0.015), impaired LVEF (HR 9.55, 95% CI 2.55 to
35.81, p = 0.001), and in(cid:976)luenza vaccination (HR 0.25, 95% CI 0.07 to 0.86, p = 0.028).
Conclusion : ACS patients who were female with dyslipidemia, elevated SCr, and impaired LVEF should be closely monitored for
HF. The in(cid:976)luenza vaccination had a signi(cid:976)icant protective effect for HF in ACS. Therefore, the bene(cid:976)it of in(cid:976)luenza vaccine should
be considered in practice for ACS patients.
Keywords : In(cid:976)luenza vaccine, Acute coronary syndrome, Heart failure, Prognostic indicators
