Os paulistas estão re-descobrindo (como novidade) o que a AMICOR Maria Inês Reinert Azambuja já havia demonstrado desde a década de 80 e divulgado pelo mundo. Depois da notícia transcrevo um artigo dela, do Lancet, relacionado com a matéria.
Segundo Incor, vacina para gripe comum também protege o coração
Pesquisadores do Incor descobriram que depois da imunização, as mortes por infarto caíram. Todo ano, mais de 80% dos idosos tomam a vacina contra a gripe comum.
E da Revista Lancet: http://www.thelancet.com/infection Vol 10 March 2010
Infl ammation as the cause of coronary heart disease
It was with great satisfaction that I saw, published in
The Lancet Infectious Diseases, a Review by Charlotte
Warren-Gash and colleagues1 on infl uenza as a trigger
for acute myocardial infarction and cardiovascular
diseases deaths.
Warren-Gash and colleagues review several recent
studies and refer to historical studies published
between the 1920s and 1970s, suggesting an
association between infl uenza and increases in
mortality due to coronary heart disease. But the
bibliography shows that there were no publications
on this topic during the 1980s and 1990s. The
classifi cation of coronary heart disease as a
degenerative condition had become so strong that it
suppressed the knowledge of a link with infl uenza for
more than 20 years. By 1990, I had been struggling
for many years to fi nd an explanation for what I had
recognised as an epidemic of coronary heart disease.
Since epidemics refl ect not just an environmental
exposure, but also a change in the rate of population
vulnerability over time, I had been looking for what
might have changed the vulnerability of the world
population causing them to die from that so-called
degenerative disease. Negative selection by two
world wars, and smoking, both happened worldwide
with eff ects expected to be limited to that period, and
although possibly contributory, were not suffi cient to
explain by themselves the noted patterns. I could not
see any other alternatives. Then I read a 1988 editorial
by Cunningham and Pasternack2 called The potential
role of viruses in the pathogenesis of atherosclerosis. Up
to that point I had not considered the rise and fall in
mortality due to coronary heart disease as having an
infectious cause. There was one infectious event that
fulfi lled the requirements of precedence, geographical
extension, and size to be thought associated with
the 20th century mortality due to coronary heart
disease: the 1918 infl uenza pandemic! After that, it
was not diffi cult to pull together the ecological and the
biological evidence to propose an association between
both events.3
In a meeting on atherosclerosis in Montréal, in 1994,
my abstract was the only one dealing with infection.3
The fi rst international symposium on infection and
atherosclerosis happened only in 1998, in France.
Several causes were being considered at that time,4
but my abstract was the only one proposing a role for
influenza.5 The fi rst paper in a peer-reviewed journal
on an association between infl uenza and coronary
heart disease was published in 2000.6 In 2002 I
published my own work on this subject in Brazil,7,8 and
in 2003 I was invited to the fi rst meeting on influenza
and cardiovascular diseases held at the Texas Heart
Institute.9,10 Since 2004, there has been growth in the
number of investigations tackling the association
between infl uenza and coronary heart disease, and
Warren-Gash and colleagues. do an excellent job
reviewing them.
The time might have arrived to seriously consider
substituting inflammation for degeneration as the
idea behind atherogenesis.11 The 2009 H1N1
pandemic is giving us the opportunity of widely
reassess the role of infection, and particularly of
influenza, on the cause of coronary heart disease.
The Review by Warren-Gash and colleagues is proof
that change is already on its way. Now it is up to us
to decide whether we are ready to advance, and how
far.12,13
Maria Inês Reinert Azambuja
Federal University of Rio Grande do Sul, Porto Alegre, RS Brazil
miazambuja@terra.com.br
I declare that I have no confl icts of interest.
1 Warren-Gash C, Smeeth L, Hayward AC. Infl uenza as a trigger for acute
myocardial infarction or death from cardiovascular disease: a systematic
review. Lancet Infect Dis 2009; 9: 601–10.
2 Cunningham MJ, Pasternack RC. The potential role of viruses in the
pathogenesis of atherosclerosis. Circulation 1988; 77: 964–66.
3 Reinert-Azambuja M. 1918–19 infl uenza pandemic and ischemic heart
disease epidemic: cause and eff ect? 10th international symposium on
atherosclerosis; Montreal, QC, Canada; Oct 9–14, 1994. Abstract 277.
4 Dodet B, Plotkin SA. Infection and atherosclerosis, Am Heart J 1999;
138 (suppl 1): S417–18.
5 Reinert-Azambuja MI. 1918 Infl uenza pandemic and the rise in CHD
mortality: cause and eff ect? Symposium on infection and atherosclerosis;
Annecy, France; Dec 6–9, 1998.
6 Naghavi M, Barlas Z, Siadaty S, Naguib S, Madjid M, Casscells W.
Association of infl uenza vaccination and reduced risk of recurrent
myocardial infarction. Circulation 2000; 102: 3039–45.
7 Azambuja MI, Duncan BB. Similarities in mortality patterns from infl uenza
in the fi rst half of the 20th century and the rise and fall of ischemic heart
disease in the United States: a new hypothesis concerning the coronary
heart disease epidemic. Cad Saude Publica 2002; 18: 557–66.
8 Azambuja MI, Duncan BB. The authors reply. Cad Saude Publica 2002;
18: 571–77.
9 Madjid M, Aboshady I, Awan I, Litowski S, Casscells S. Infl uenza and
cardiovascular diseases—is there a causal relationship? Texas Heart Inst J
2004; 31: 4–13.
10 Azambuja MI. Spanish flu and early 20th century expansion of a
coronary heart disease-prone subpopulation. Texas Heart Inst J 2004;
31: 14–21.
11 Ridker PM. C-Reactive Protein and the prediction of cardiovascular events
among those at intermediate risk: moving an infl ammatory hypothesis
toward consensus. JACC 2007; 49: 2129–38.
12 Azambuja MI, Achutti AA, Levins R. The infl ammation paradigm: Towards a
consensus to explain coronary heart disease mortality in the 20th century.
CVD Prev Control 2008; 3: 69–76.
13 Azambuja MI. Connections: can the 20th century coronary heart disease
epidemic reveal something about the 1918 infl uenza lethality?
Braz J Med Biol Res 2008; 41: 1–4.
Acinetobacter baumannii infections in children
In their
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