Flu Vaccination in Congestive Heart Failure (FLUVACS-IC)

This study has been completed.
Sponsor:
Information provided by:
La Fundacion Favaloro para la Investigacion y la Docencia Medica
ClinicalTrials.gov Identifier:
NCT00664339
First received: April 17, 2008
Last updated: NA
Last verified: April 2008
History: No changes posted

April 17, 2008
April 17, 2008
May 2007
March 2008   (final data collection date for primary outcome measure)
Total Death [ Time Frame: 6 mounths ] [ Designated as safety issue: No ]
Same as current
No Changes Posted
Rehospitalization for any cause or infarction [ Time Frame: 6 mounths ] [ Designated as safety issue: No ]
Same as current
Not Provided
Not Provided
 
Flu Vaccination in Congestive Heart Failure
Influenza Vaccine Pilot Study in Severe Congestive Heart Failure Patients. The Flu Vaccination Heart Failure (FLUVACS II) Study

We evaluated the preventive impact of vaccination on subsequent death events in 117 severe congestive heart patients requiring ventilator support without endotracheal intubations and aggressive medical therapy.

They were randomly allocated in a single-blind manner as a unique intramuscular influenza vaccination or as controls.

The first primary outcome evaluated at 6 months follow-up - cardiovascular death - occurred in 3% of the patients in the vaccine group Vs 17% in controls (p=0.022). The composite end point occurred in 33% of the patients in the vaccine group Vs 74% in control group, p = <0.001.

Background: Recent reports detected that one of the barriers that vaccination against influenza infection is that, physicians do not strongly recommend its applications to cardiovascular patients at risk. We evaluated the preventive impact of vaccination against death in severe congestive heart failure hospitalized patients.

Methods and Results: A total of 117 severe congestive heart failure patients (New York Heart Association class III and IV) admitted in the first 12 hours who required ventilator support without endotracheal intubations and high doses of loop-diuretics, were included in a prospective, multicenter log, during the winter season. Congestive heart patients received intravenous vasodilators and loop-diuretics plus standard therapies, and then were randomly allocated in a single-blind manner as a unique intramuscular influenza vaccination or as controls. Death, and combined end points (death, and re-hospitalization for any reason) were assessed at 6 months follow-up.

The first primary outcome - cardiovascular death - occurred in 3% of the patients in the vaccine group Vs 17% in controls (odds ratio with vaccine as compared with controls: 0.16; 95 percent confidence interval, 0.33 to 0.79; p=0.022). The composite end point occurred in 33% of the patients in the vaccine group Vs 74% in controls, p = <0.001. The need of adding inotropic drugs occurred in 8% of patients receiving vaccination, and in 12.5% in the control group.

Interventional
Phase 4
Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Single Blind (Subject)
Primary Purpose: Prevention
Heart Failure
  • Biological: Flu Vaccine
    Single dose of Flu vaccine by year (1)
  • Other: Conventional medical therapy for heart failure
    According with the international guidelines
  • Active Comparator: Vaccine
    Flu Vaccine
    Intervention: Biological: Flu Vaccine
  • Control
    Conventional treatment therapy for heart failure
    Intervention: Other: Conventional medical therapy for heart failure
Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Completed
117
March 2008
March 2008   (final data collection date for primary outcome measure)

Inclusion Criteria:

  • Male or female patient's > 21 years of age with a severe congestive heart failure (New York Heart Association class III or IV) requiring an immediate administration of intravenous vasodilators drugs, oxygen therapy, and no less than 160 mg of intravenous furosemide were eligible for inclusion.
  • Definite evidence of underlying heart failure was also required as shown by at least two of the following:

    • a) Orthopnea on admission
    • b) X-ray showing evidences of elevated wedge pressure indicating congestive heart failure
    • c) recent prior hospitalization (within the 30 days prior to the index hospitalization) because a congestive heart failure episode
    • d) echocardiography data showing a poor left ventricular ejection fraction (0.40 or lower measuring with the biplane Simpson's method
    • e) non-invasive ventilation to the maintenance of SaO2 above 90%
    • f) wet rales in at least the lower half of the lungs fields
  • Patients with a final diagnosis of Congestive Heart Failure as a consequence of necrotic or chronic ischemic heart disease, or infective origin such as chronic Chagas Disease, chronic valvular heart disease (surgically repaired or not), and idiopathic origin were also included for the present study

Exclusion Criteria:

  • Patients with a concomitant infective disease were excluded from the study
  • Patients with evidence of evolving with multi organic failure (hepatic or renal dysfunction requiring dialysis), terminal disease, or any impeding cause of follow-up, including contraindications of vaccination, were excluded from the study
  • Those with congestive heart failure following unstable coronary artery disease, or prior by-pass surgery, or angioplasty or congestive heart failure complicating myocardial infarction requiring urgent intervention were excluded also
  • Those individuals who required mechanical ventilation on admission
  • Patients with prior vaccinations were also excluded
  • Pregnancy condition was an exclusion criterion
  • Those patients who were unable or refused to give a written inform consent was also excluded of the present study
Both
21 Years to 90 Years
No
Contact information is only displayed when the study is recruiting subjects
Not Provided
 
NCT00664339
DDI (976) 407
Yes
ENRIQUE P. GURFINKEL, MD PhD, Fundacion Favaloro para la Docencia y la Investigacion Medica
La Fundacion Favaloro para la Investigacion y la Docencia Medica
Not Provided
Study Chair: ENRIQUE P GURFINKEL, MD PhD FUNDACION FAVALORO PARA LA DOCENCIA Y LA INVESTIGACION MEDICA
La Fundacion Favaloro para la Investigacion y la Docencia Medica
April 2008

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP