Conclusions
DISEASE, EVENTS, SECONDARY, INFLUENZA
In this secondary analysis of the INVESTED randomized clinical trial evaluating the efficacy of high-dose trivalent vaccine compared with standard-dose quadrivalent vaccine in reducing CP events among patients with high-risk CV disease in the US, influenza activity was temporally associated with an increasing risk of CP events, yet a higher-dose influenza vaccine did not significantly reduce temporal CV risk. Other seasonal factors may also play a role in the higher rate of CV events associated with high rates of influenza. Further studies and additional measures are needed to understand additional factors influencing the temporal association between influenza and CV events and to assess new strategies to reduce events.