b'tovaccinateapatientisindividuallybasedandwith RSV infection as among similarly aged hospi-informedbydiscussionsbetweenthepatientandtalized adults with laboratory-confirmed influenza or health care provider (anyone who provides or admin- COVID-19infection(4.1%to9.0%forinfluenza-istersvaccines,includingprimarycarephysicians,associatedhospitalizationsand5.1%to7.8%for specialists,physicianassistants,nursepractitioners,COVID-associated hospitalizations, depending on the registered nurses, and pharmacists). age group).TherecentstudysuggestedthatcomprehensiveThe study advised that the pathophysiology by which dataaboutpotentialcardiaccomplicationsofRSVrespiratory viral infection could result in acute car-infection, similar to what are available for hospitaliza- diac events has not been established. It posited that it tions for influenza or SARS-CoV-2 infections, couldmight include both pathogen-specific and nonspecific help guide clinical and public health practices, char- mechanisms.Hypothesizedmechanismsinclude acterize the burden of RSV-associated cardiovascularincreasedcytokine-relatedinflammatoryresponses disease prior to the introduction of novel vaccines,thatcontributetocoronaryplaquedestabilization, and prompt studies evaluating the prevention of acutehypercoagulability resulting in an increased risk of cardiac events through RSV vaccination.thromboses, demand ischemia due to physiologic and The research focused on adults 50 years or older,metabolic stress from acute respiratory illness, direct becausethatcohortaccountsformorethan90%myocardialinjury,andindirectconsequencesfrom of RSV-associated hospitalizations of adults in thethe strain on the respiratory tract, all of which may UnitedStates.Inaddition,thestudyteamaddedoccur with RSV infection, according to the study. that their results are important In light of emerg- TheauthorspointoutthatbothRSVvaccines ing clinical trial data in adults age 50 to 59 years,approved for adults were shown to be effective in whichcouldexpandRSVvaccinationtoyoungerpreventingsymptomaticRSVlowerrespiratory age groups. Additionally, we sought to identify risktract disease in older adults but added that clini-factors for experiencing an acute cardiac event andcal trials were underpowered to estimate effective-to determine whether acute cardiac events are inde- ness against more severe disease, including disease pendently associated with increased risk of severerequiring hospitalization.outcomes during hospitalization. Prevention of acute cardiac events may be another Results from the study bolstered previous findingsimportant consideration for postlicensure studies of thatacuteheartfailure,coronaryeventsandatrialthe impact of RSV vaccines, especially among older fibrillationoccurfrequentlyamongadultshospi- adults with risk factors for such events identified in this talizedwithacuterespiratoryinfections,includingstudy, they suggested. Indeed, influenza vaccination influenza and SARS-CoV-2. Notably, we found thathas been associated with reduced risk of acute cardio-14.5% of hospitalized adults aged 50 years or oldervascular events in the hospital setting. With additional with RSV infection experienced acute heart failure,candidate RSV vaccines in clinical trials and potential the authors wrote. This prevalence was higher thanexpansion of RSV vaccination to adults age 50 to 59 in similarly aged hospitalized adults with laboratory- years, interest in this topic is likely to grow. confirmedinfluenzaorCOVID-19infection(5.5%Thisstudydemonstratestheprevaccineepi-to 9.0% for influenza-associated hospitalizations anddemiology of acute cardiac events among adults 4.0% to 8.5% for COVID-19associated hospitaliza- with RSV-associated hospitalization, which repre-tions, depending on the age group) and is consistentsents a substantial burden of potentially vaccine-with prior studies indicating that adults with chronicpreventable disease.heartfailureareatincreasedriskofsevereillness1Woodruff RC, Melgar M, Pham H, et al. Acute Cardiac Events in from RSV infection. Hospitalized Older Adults With Respiratory Syncytial Virus Infection. AcuteischemicheartdiseaseoccurredasoftenJAMA Intern Med. Published online April 15, 2024. doi:10.1001/ja-amonghospitalizedadultsaged50yearsoroldermainternmed.2024.02125'