Cardiovascular disease has a great burden in the context of public health, as well as the low pharmacological adherence of patients who have chronic non-transmissible diseases. However, the investigators do not have data on the efficacy of vaccination to reduce cardiovascular events in the acute coronary syndromes, and the few studies evaluating the cardioprotective potential of the influenza vaccine were conducted in countries with well defined seasonalities, divergent of Brazil, that presents a constant viral circulation during all months of the year and distinct among its regions. Therefore, study evaluating higher dose vaccination in a period that contemplates the seasonality of the influenza virus in Brazil may bring important findings to different scientific gaps, as well as clarify questions about the possible benefit of doubled vaccination - which does not present contraindications - immediately after a atherothrombotic event. If it shows real benefit, it could also be a future therapeutic tool adjuvant to traditional drug therapy in the prevention of cardiovascular events.
Phase III, randomized, controlled, multicenter, open-label, superiority, 1:1 allocation, blind assessment of clinical outcomes and intention-to-treat analysis clinical trial to determine whether increased doses(double dose) of influenza vaccine in the hospital phase, when compared to usual dose vaccination (30 days of randomization), decreases the risk of cardiovascular and respiratory events. Hospitalizations due to COVID-19 are excluded from the respiratory infection component of the primary outcome.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
1,801
Double Dose QIV (30µg Hemagglutinin)
Standard Dose QIV (15µg Hemagglutinin)
Universidade Federal do Ceará / Hospital Universitário Walter Cantídio
Fortaleza, Ceará, Brazil
Hospital e Clínica São Roque
Ipiaú, Estado de Bahia, Brazil
Hospital Ana Nery
Salvador, Estado de Bahia, Brazil
Hospital Cárdio Pulmonar
Salvador, Estado de Bahia, Brazil
Instituto de Cardiologia do Distrito Federal
Brasília, Federal District, Brazil
Hospital Universitário Ciências Médicas
Belo Horizonte, Minas Gerais, Brazil
Hospital Santa Lucia
Poços de Caldas, Minas Gerais, Brazil
Hospital Universitario da Universidade Estadual de Londrina
Londrina, Paraná, Brazil
Hospital Agamenon Magalhães
Recife, Pernambuco, Brazil
Pronto Socorro Cardiológico de Pernambuco
Recife, Pernambuco, Brazil
...and 12 more locations
Hierarchical composite endpoint consisting of death, myocardial infarction, stroke, unstable angina hospitalization, heart failure hospitalization, urgent coronary revascularization or respiratory infections hospitalizations
The primary objective will be analyzed using the win ratio approach comparing every participant of treatment group to every participant of control group to determine a winner
Time frame: 12 months
Key Secondary End Point is a hierarchical outcome consisting only of cardiovascular death, myocardial infarction or stroke.
The key secondary end point will be analyzed using the win ratio approach comparing every participant of treatment group to every participant of control group to determine a winner
Time frame: 12 months
Total mortality
Time to first occurrence of all cause death
Time frame: 12 months
Cardiovascular mortality
Time to first occurrence of CV death
Time frame: 12 months
Myocardial infarction
Time to first occurrence of myocardial infarction
Time frame: 12 months
Unstable angina hospitalization
Time to first occurrence of Unstable angina hospitalization
Time frame: 12 months
Stroke
Time to first occurrence of stroke
Time frame: 12 months
TIA (Transient ischemic attack)
Time to first occurrence of TIA
Time frame: 12 months
Heart failure hospitalizations
Time to first occurrence of Heart failure hospitalizations
Time frame: 12 months
Respiratory infections hospitalizations
Time to first occurrence of hospitalization due to upper and lower respiratory tract infection (excluding COVID-19)
Time frame: 12 months
Need for myocardial revascularization
Time to first occurrence of urgent coronary revascularization ischemia guide (urgent or not-urgent)
Time frame: 12 months
Stent thrombosis
Time to first occurrence of probable and definite stent thrombosis
Time frame: 12 months
COVID-19 hospitalizations
Time to first occurrence of COVID-19 hospitalizations
Time frame: 12 months
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