{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T09:28:46Z","timestamp":1793957326097,"version":"4.8.0"},"reference-count":48,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:00:00Z","timestamp":1747180800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Background: Major adverse cardiovascular events (MACE), including myocardial infarction, stroke, and cardiovascular death, are the leading contributors to global morbidity and mortality worldwide. Accumulating evidence suggests a strong association between influenza infection and increased risk of MACE, especially in high-risk populations. Influenza vaccination has been proposed as a potential strategy for reducing this risk by mitigating systemic inflammation and preventing atherosclerotic plaque destabilization, although the precise mechanisms remain under investigation. Results: Multiple meta-analyses and RCTs suggest that influenza vaccination is associated with a reduced risk of MACE, particularly in high-risk individuals with preexisting cardiovascular disease, but the results are less consistent for primary prevention in low-risk populations. The current data support the importance of early and annual vaccination for optimizing cardiovascular outcomes. Conclusions: Influenza vaccination is emerging as an effective and accessible strategy to reduce the risk of major adverse cardiovascular events, particularly in high-risk individuals. While further research is needed to clarify its role in low-risk populations and the underlying mechanisms of protection, current evidence supports its integration into cardiovascular preventive care.<\/jats:p>","DOI":"10.3390\/vaccines13050522","type":"journal-article","created":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T10:27:41Z","timestamp":1747218461000},"page":"522","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Is Influenza Vaccination Our Best \u2018Shot\u2019 at Preventing MACE? Review of Current Evidence, Underlying Mechanisms, and Future Directions"],"prefix":"10.3390","volume":"13","author":[{"given":"Alexia","family":"El Khoury","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases & HIV Medicine, University Hospitals Cleveland Medical Center, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joy","family":"Abou Farah","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases & HIV Medicine, University Hospitals Cleveland Medical Center, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2514-3820","authenticated-orcid":false,"given":"Elie","family":"Saade","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases & HIV Medicine, University Hospitals Cleveland Medical Center, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Bosco, E., Hsueh, L., McConeghy, K.W., Gravenstein, S., and Saade, E. 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