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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Evaluating clinical effectiveness of pneumococcal vaccination in preventing stroke: The CAPAMIS study, 3-year follow-up
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Evaluating clinical effectiveness of pneumococcal vaccination in preventing stroke: The CAPAMIS study, 3-year follow-up

机译：评估肺炎球菌疫苗预防中风的临床效果：CAPAMIS研究，为期3年的随访

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Background Cerebrovascular benefits using the 23-valent pneumococcal polysaccharide vaccine (PPV23) are controversial. This study assessed clinical effectiveness of PPV23 in preventing ischemic stroke in people older than 60 years. Methods We conducted a population-based cohort study involving 27,204 individuals of 60 years or older in Tarragona, Spain, who were prospectively followed from December 01, 2008, until November 30, 2011. Outcomes were neuroimaging-confirmed ischemic stroke, 30-day mortality from stroke, and all-cause death. Pneumococcal vaccination effectiveness was evaluated by Cox regression analyses, estimating hazard ratios (HRs) adjusted for age, sex, comorbidities, and influenza vaccine status. Results Cohort members were followed for a total of 76,033 person-years, of which 29,065 were for vaccinated subjects. Overall, 343 cases of stroke, 45 deaths from stroke, and 2465 all-cause deaths were observed. Pneumococcal vaccination did not alter the risk of stroke (multivariable HR: 1.04; 95% confidence interval [CI]:.83-1.30; P =.752), death from stroke (HR: 1.14; 95% CI:.61-2.13; P =.686), and all-cause death (HR:.97; 95% CI:.89-1.05; P =.448). In analyses focused on people with and without a history of cerebrovascular disease, the PPV23 did not emerge effective in preventing any analyzed event, but influenza vaccine emerged independently associated with a reduced risk of death from stroke (HR:.51; 95% CI:.28-.93; P =.029) and all-cause death (HR:.73; 95% CI:.67-.81; P <.001). Conclusions Our data support that the PPV23 does not provide benefit against ischemic stroke, but it also supports a beneficial effect of influenza vaccine in reducing specific- and all-cause mortality risk in the general population older than 60 years.
机译：背景技术使用23价肺炎球菌多糖疫苗（PPV23）的脑血管益处存在争议。这项研究评估了PPV23预防60岁以上人群缺血性卒中的临床效果。方法我们在西班牙塔拉戈纳进行了一项基于人群的队列研究，研究对象为27204名60岁或60岁以上的个体，从2008年12月1日至2011年11月30日进行了随访。结果为神经影像证实的缺血性卒中，30天死亡率中风和全因死亡。通过Cox回归分析评估了肺炎球菌疫苗接种的有效性，并评估了针对年龄，性别，合并症和流感疫苗状况进行调整的危险比（HRs）。结果队列成员共随访76,033人年，其中29,065人为疫苗接种者。总体上，观察到343例中风病例，45例中风死亡和2465例全因死亡。肺炎球菌疫苗接种并未改变中风的风险（多变量HR：1.04; 95％置信区间[CI] ：. 83-1.30; P = .752），中风死亡（HR：1.14; 95％CI：.61-2.13） ; P = .686）和全因死亡（HR：.97; 95％CI：.89-1.05; P = .448）。在针对有或没有脑血管病史的人群的分析中，PPV23未能有效预防任何分析事件，但流感疫苗独立出现，与卒中死亡风险降低相关（HR：.51; 95％CI： .28-.93; P = .029）和全因死亡（HR：.73; 95％CI：.67-.81; P <.001）。结论我们的数据支持PPV23不能提供抗缺血性卒中的益处，但它也支持流感疫苗在降低60岁以上普通人群中因特定原因和全因引起的死亡风险中的有益作用。

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