THE BE T
Patient Focus
CARDIOSMART CORNER
Cardiologists Should Stress the Importance of Vaccinations for Patients
Throughout the month of August, we recognize National Immunization Awareness Month, which was established to encourage
people of all ages to make sure they are up to date on the vaccines
recommended for them. Vaccines, like the flu and shingles vaccines,
are even more important for people with cardiovascular disease as
they are at a high risk for developing serious complications from flu
infection or shingles.
People with heart disease may have a three times increased
risk of flu-related hospitalization. Studies have shown that patients
with heart disease who receive a flu vaccine had a decreased risk
of acute coronary syndrome and heart disease-related deaths.
The ACC, American Heart Association and the Centers for Disease
Control and Prevention (CDC) recommend an annual influenza vaccine for secondary prevention of cardiac-related events in persons
with coronary and other atherosclerotic vascular disease, including stroke. However, in recent years, less than half of people 18-64
years with heart disease were vaccinated during flu season. It is
important for cardiologists to recommend the yearly flu vaccine to
their patients, or to even provide them in their practice.
Patients with heart disease may also need other vaccinations
such as the pneumococcal polysaccharide vaccine and additional
vaccines based on certain considerations, such as the patient’s age. Martha Gulati, MD, MS
CardioSmart Editor-in-Chief
The shingles vaccine is recommended for people aged 60 years
or older, yet only 9% of eligible patients have received it. Anyone
who has had chickenpox can get shingles, which increases the
risk of stroke and heart attack. The shingles vaccine is a one-time,
single-dose shot. Patients can visit CardioSmart.org for information
to help them decide whether different vaccines are right for them.
“Silent” Heart Attacks
Common in Middle-aged Adults
Nearly half of all heart attacks go unnoticed in
middle-aged adults, according to the results of a
large U.S. study published in Circulation.
The ARIC (Atherosclerosis Risk in Communities)
study followed nearly 9,500 U.S. adults to investigate risk factors related to heart disease. Participants were 54 years old on average and free of
heart disease at the start of the study. Across an
average of 9 years, participants completed interviews and medical exams, including electrocardiograms, to assess their health and lifestyle.
During the follow-up period, 4% of participants had been diagnosed with heart attack.
But upon further investigation, another 3% of
participants had “silent” heart attacks based on
ECG results. Overall, silent heart attacks accounted for 45% of all heart attacks in the study.
Based on analysis, adults with evidence of silent
heart attacks had 34% greater risk of death than
adults with no history of heart attack. Researchers also noted that while silent heart attacks
were more common in men than women, silent
heart attacks were associated with greater risk
of death in women.
According to researchers, the findings highlight the need for better detection of silent heart
attacks. It’s important that patients know their
cardiovascular risk to properly address any risk
factors they may have. They add that future
research to explore both sex and race differences related to silent heart attacks is needed.
With additional research, experts hope to better understand silent heart attacks and improve
outcomes for all heart attack patients. ■
Zhu-Ming Zhang, Pentti M. Rautaharju, etc. Circulation. 2016;doi:
10.1161/CIRCULATIONAHA.115.021177
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CardioSource WorldNews
August 2016