Use of Oseltamivir after influenza infection is associated with reduced incidence of recurrent adverse cardiovascular outcomes among military health system beneficiaries with prior cardiovascular diseases

S. Ward Casscells, Elder Granger, Amii Kress, Andrea Linton, Mohammad Madjid, Linda Cottrell

Research output: Contribution to journalArticle

Abstract

Background-Influenza infection has been associated with increased risk of adverse cardiac and cerebral vascular outcomes. Oseltamivir, a treatment for influenza, has been shown to decrease the severity of an influenza episode, but few data exist regarding its potentially protective effect against recurrent vascular outcomes among influenza patients with a history of vascular disease. Methods and Results-Electronic healthcare service and pharmacy records for 37 482 TRICARE beneficiaries, aged 18 and older, with a coded history of cardiovascular (CV) disease and a subsequent diagnosis of influenza from October 1,2003, through September 30, 2007, were examined. Subjects were grouped according to whether they had filled a prescription for oseltamivir within 2 days of their influenza diagnosis. The incidence of recurrent CV events within 30 days after the influenza diagnosis among oseltavmivir-treated and untreated subjects was 8.5% and 21.2%, respectively (P<0.005). Subject age was a persistent and significant contributor to the likelihood of recurrent CV outcomes. After controlling for the differences in demographics among treated and untreated cohorts using a propensity-scored logistic regression model, a statistically significant protective effect was associated with oseltamivir treatment (odds ratio, 0.417; 95% CI, 0.349 to 0.498). Conclusions-Our findings suggests that oseltamivir treatment for influenza is associated with significant decrease in the risk of recurrent CV events in subjects with a history of CV disease. These findings merit confirmation in further prospective and controlled studies. Meanwhile, in patients with CV disease, strict adherence with current practice guidelines for prevention and treatment of influenza is recommended.

Original languageEnglish (US)
Pages (from-to)108-115
Number of pages8
JournalCirculation: Cardiovascular Quality and Outcomes
Volume2
Issue number2
DOIs
StatePublished - Mar 1 2009
Externally publishedYes

Fingerprint

Oseltamivir
Human Influenza
Cardiovascular Diseases
Incidence
Health
Infection
Blood Vessels
Logistic Models
Pharmaceutical Services
Therapeutics
Vascular Diseases
Practice Guidelines
Prescriptions
Odds Ratio
Demography
Prospective Studies
Delivery of Health Care

Keywords

  • Complications
  • Epidemiology
  • Follow-up studies
  • Prevention

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Use of Oseltamivir after influenza infection is associated with reduced incidence of recurrent adverse cardiovascular outcomes among military health system beneficiaries with prior cardiovascular diseases. / Casscells, S. Ward; Granger, Elder; Kress, Amii; Linton, Andrea; Madjid, Mohammad; Cottrell, Linda.

In: Circulation: Cardiovascular Quality and Outcomes, Vol. 2, No. 2, 01.03.2009, p. 108-115.

Research output: Contribution to journalArticle

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abstract = "Background-Influenza infection has been associated with increased risk of adverse cardiac and cerebral vascular outcomes. Oseltamivir, a treatment for influenza, has been shown to decrease the severity of an influenza episode, but few data exist regarding its potentially protective effect against recurrent vascular outcomes among influenza patients with a history of vascular disease. Methods and Results-Electronic healthcare service and pharmacy records for 37 482 TRICARE beneficiaries, aged 18 and older, with a coded history of cardiovascular (CV) disease and a subsequent diagnosis of influenza from October 1,2003, through September 30, 2007, were examined. Subjects were grouped according to whether they had filled a prescription for oseltamivir within 2 days of their influenza diagnosis. The incidence of recurrent CV events within 30 days after the influenza diagnosis among oseltavmivir-treated and untreated subjects was 8.5{\%} and 21.2{\%}, respectively (P<0.005). Subject age was a persistent and significant contributor to the likelihood of recurrent CV outcomes. After controlling for the differences in demographics among treated and untreated cohorts using a propensity-scored logistic regression model, a statistically significant protective effect was associated with oseltamivir treatment (odds ratio, 0.417; 95{\%} CI, 0.349 to 0.498). Conclusions-Our findings suggests that oseltamivir treatment for influenza is associated with significant decrease in the risk of recurrent CV events in subjects with a history of CV disease. These findings merit confirmation in further prospective and controlled studies. Meanwhile, in patients with CV disease, strict adherence with current practice guidelines for prevention and treatment of influenza is recommended.",
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