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Evaluating clinical effectiveness of pneumococcal vaccination in preventing stroke: the CAPAMIS Study, 3-year follow-up.
Vila-Corcoles, Angel; Ochoa-Gondar, Olga; Rodriguez-Blanco, Teresa; de Diego-Cabanes, Cinta; Satue-Gracia, Eva; Vila-Rovira, Angel; Torrente Fraga, Cristina.
Afiliación
  • Vila-Corcoles A; Primary Care Service "Camp de Tarragona", Institut Catala de la Salut, Tarragona, Spain.
  • Ochoa-Gondar O; Primary Care Service "Camp de Tarragona", Institut Catala de la Salut, Tarragona, Spain. Electronic address: oochoa.tarte.ics@gencat.cat.
  • Rodriguez-Blanco T; Primary Care Research Institute, Institut d'Investigacio en Atencio Primaria Jordi Gol, Autonomous University of Barcelona, Barcelona, Spain.
  • de Diego-Cabanes C; Primary Care Service "Camp de Tarragona", Institut Catala de la Salut, Tarragona, Spain.
  • Satue-Gracia E; Primary Care Service "Camp de Tarragona", Institut Catala de la Salut, Tarragona, Spain.
  • Vila-Rovira A; Research Assistance on Mortality Data, Institut d'Investigacio en Atencio Primaria Jordi Gol, Barcelona, Spain.
  • Torrente Fraga C; Primary Care Service "Camp de Tarragona", Institut Catala de la Salut, Tarragona, Spain.
J Stroke Cerebrovasc Dis ; 23(6): 1577-84, 2014 Jul.
Article en En | MEDLINE | ID: mdl-24656243
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.
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Texto completo: 1 Base de datos: MEDLINE Asunto principal: Isquemia Encefálica / Accidente Cerebrovascular / Vacunas Neumococicas Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: J Stroke Cerebrovasc Dis Asunto de la revista: ANGIOLOGIA / CEREBRO Año: 2014 Tipo del documento: Article País de afiliación: España

Texto completo: 1 Base de datos: MEDLINE Asunto principal: Isquemia Encefálica / Accidente Cerebrovascular / Vacunas Neumococicas Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: J Stroke Cerebrovasc Dis Asunto de la revista: ANGIOLOGIA / CEREBRO Año: 2014 Tipo del documento: Article País de afiliación: España