CARDIOVASCULAR DISEASES ASSOCIATED WITH INFLUENZA INFECTION: SYSTEMATIC REVIEW AND META-ANALYSIS

Caycho Torres, M. d. C.; Clavo Yamahuchi, J.; Cornejo Ramos, C.; Diaz Gomez, K. A.; Zanoni Ramos, O.; Gayoso Liviac, A.; Ugarte-Gil, C.; Vega Zambrano, V.

Background: Cardiovascular diseases represent important diagnoses that can become fatal if an early and adequate management is not carried out. Since 1930, a possible relationship between these events and influenza virus infection has been proposed. Objectives: To determine the association between cardiovascular diseases and previous infection by influenza virus. Materials and methods: A systematic review was carried out according to PRISMA. The electronic search was carried out in the databases of EMBASE, PubMed, Global Index Medicus, Google Scholar and Cochrane Library. The included studies had laboratory-confirmed influenza in patients over 18 years of age; studies that considered pregnant patients or animals were excluded. The quality of the studies was verified using the standardized tool of the National Heart Lung and Blood Institute and the certainty of the results was assessed with GRADE. In addition, 2 meta-analysis of the association measures were performed using the Cochrane Software Review Manager 5.4.1. Results: 31 records were identified, of which 4 were included (n = 1101). These studies were conducted in Finland, China, and Australia. The estimated combined OR for the positive association between influenza A and acute myocardial infarction obtained was 2.52 (95% CI 1.59 - 4); and in the association with influenza B, an OR of 4.78 ( 95% CI 1.57-14.61). The OR obtained for the association with myocarditis was 5.23 (95% CI 1.00 - 27.32). Conclusions: Evidence of almost 5 times the risk of suffering acute myocardial infarction was found in those who had a previous episode of influenza B, and almost 3 with influenza A. Better quality longitudinal studies are required to confirm this finding.