Correspondence

Care after Coronary-Artery Bypass Surgery

N Engl J Med 2003; 349:307July 17, 2003

Article

To the Editor:

In their article on care after coronary-artery bypass surgery, Charlson and Isom (April 10 issue)1 did not discuss the value of influenza vaccination. Influenza vaccination reduces the risk of myocardial infarction in patients with coronary artery disease,2 reduces the risk of hospitalization for stroke and cardiac disease in elderly persons,3 and reduces the risk of future ischemic events in patients who have a myocardial infarction or who undergo percutaneous angioplasty or receive a stent during influenza season.4 Thus, annual influenza vaccination should be an integral part of the management of care after coronary-artery bypass grafting. A pneumococcal vaccine can be administered simultaneously (once) with the influenza vaccine in patients who have not yet received it.5

Rachel Sorokin, M.D.
Jefferson Medical College, Philadelphia, PA 19107
rachel.sorokin@mail.tju.edu

5 References

1. 1

   Charlson ME, Isom OW. Care after coronary-artery bypass surgery. N Engl J Med 2003;348:1456-1463
   Full Text | Web of Science | Medline

2. 2

   Naghavi M, Barlas Z, Siadaty S, Naguib S, Madjid M, Casscells W. Association of influenza vaccination and reduced risk of recurrent myocardial infarction. Circulation 2000;102:3039-3045
   Web of Science | Medline

3. 3

   Nichol KL, Nordin J, Mullooly J, Lask R, Fillbrandt K, Iwane M. Influenza vaccination and reduction in hospitalizations for cardiac disease and stroke among the elderly. N Engl J Med 2003;348:1322-1332
   Full Text | Web of Science | Medline

4. 4

   Gurfinkel EP, de la Fuente RL, Mendiz O, Mautner B. Influenza vaccine pilot study in acute coronary syndromes and planned percutaneous coronary interventions. Circulation 2002;105:2143-2147
   CrossRef | Web of Science | Medline

5. 5

   Bridges CB, Fukuda K, Uyeki TM, et al. Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2002;51:1-31
   Medline

Author/Editor Response

We agree with Dr. Sorokin that patients who have had coronary-artery bypass surgery should be vaccinated against influenza. The Centers for Disease Control and Prevention recommends influenza vaccination for older persons, patients with chronic cardiopulmonary disease, and patients with other chronic illnesses.1

Mary Charlson, M.D.
O. Wayne Isom, M.D.
Weill Medical College, New York, NY 10021
mecharl@med.cornell.edu

1 References

1. 1

   Bridges CB, Fukuda K, Uyeki TM, et al. Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2002;51:1-31
   Medline