- Title
- Potential cardioprotective effect of pneumococcal vaccine
- Creator
- Ren, Shu
- Relation
- University of Newcastle Research Higher Degree Thesis
- Resource Type
- thesis
- Date
- 2021
- Description
- Research Doctorate - Doctor of Philosophy (PhD)
- Description
- Animal and observational clinical studies have shown a strong correlation between pneumococcal polysaccharide vaccine (PPV) and reduced risk of atherosclerosis. This thesis attempts to further explore the mechanism of action of PPV’s cardioprotective effect and the public health implications of this discovery. Our meta-analysis and systematic literature review in 2015 of available clinical data at the time reported a reduction of 17% in the odds of acute coronary syndrome for PPV in the elderly. The review also identified the need for a randomised controlled trial (RCT) to confirm the observed association. The Australian Study for the Prevention through Immunisation of Cardiovascular Events (AUSPICE) is the first multi-centre, placebo-controlled, prospectively registered RCT (on US, World Health Organisation, Australia and New Zealand trial registries) to formally examine the relationship between PPV and cardiovascular outcomes. This thesis includes the published protocol design in 2016. The interim 2-year follow-up report on clinical markers of atherosclerosis in a sub-group study did not show significant changes between the PPV and placebo groups. The 4-year follow-up results of primary outcomes (ischaemic cardiovascular events) and antibodies against oxidised low-density lipoprotein will help us to better understand the mechanism of cardioprotective effect of PPV that we observed in previous studies. Our retrospective analysis of hospital admission data from the local Hunter Community Study showed that PPV was also associated with a 35% reduction in bed-days for cardiovascular admissions. An economic analysis was conducted using findings from this study and the 2015 meta-analysis. The cost-utility modelling showed that a even a small increase in PPV vaccination rate in the elderly population would lead to cost saving for the Australian government and improved quality-adjusted life years, mostly through reduced hospital admissions for acute coronary syndrome events. If the cardioprotective effect of PPV is established in AUSPICE future follow-up, and given above research findings, it would have public health implications worth considering for health policy decision making in the use of vaccination for the prevention of cardiovascular disease.
- Subject
- pneumococcal polysaccharide vaccine (PPV); cardioprotective effect; ischaemic cardiovascular events; hospital admission data; cardiovascular admissions; thesis by publication
- Identifier
- http://hdl.handle.net/1959.13/1514191
- Identifier
- uon:56822
- Rights
- Copyright 2021 Shu Ren
- Language
- eng
- Full Text
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| Thumbnail | File | Description | Size | Format | |||
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| View Details Download | ATTACHMENT01 | Thesis | 6 MB | Adobe Acrobat PDF | View Details Download | ||
| View Details Download | ATTACHMENT02 | Abstract | 203 KB | Adobe Acrobat PDF | View Details Download |