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RecruitingNCT06336317ELIMINATEUpdated Apr 7, 2026

Effect of infLuenza vaccInation After Myocardial INfArction on Cardiac inflammaTory responsE

A Phase 4 interventional study of Influenza vaccine and Placebo in Acute Myocardial Infarction, Cardiovascular Diseases and Inflammatory Response, sponsored by Region Örebro County. Recruiting at 3 sites in 3 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-04-07.

Sponsored by Region Örebro County · Phase 4, Interventional, and Treatment

Phase
Phase 4
Study type
Interventional
Enrollment
90
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

The goal of this randomized, double-blind, placebo-controlled clinical trial is to investigate the immunological effects of influenza vaccination outside of the influenza season on arterial inflammation in patients with a recent acute myocardial infarction (AMI). The primary objective is to compare the effects of influenza vaccination to those of a placebo in reducing post-myocardial infarction coronary inflammation as measured by coronary computed tomography angiography (CCTA). The main questions it aims to answer are:

Does influenza vaccination reduce arterial inflammation as measured by CCTA at week 8 after percutaneous coronary intervention (PCI) in comparison to baseline? Does influenza vaccination modulate systemic inflammation as measured by blood biomarkers and in-vitro challenge tests at week 8 after PCI in comparison to baseline? Researchers will compare the effects of influenza vaccination with those of a placebo.

Read the detailed description

Following informed consent patients are randomized in a 1:1 fashion to influenza vaccination or placebo up to 7 days following PCI. Blood tests for immune cell phenotyping and transcriptomic and proteomic analyses will be collected at baseline and 8 weeks after study inclusion. Patients will undergo CTCA at baseline (≤ 7 days of an AMI) and 8 weeks after PCI.

02

Conditions studied

  • Acute Myocardial Infarction
  • Cardiovascular Diseases
  • Inflammatory Response

Keywords

  • Coronary computed tomography angiography
  • Percutaneous coronary intervention
  • Influenza vaccine
  • Non ST-segment elevation myocardial infarction
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Patients with a diagnosis of non-ST-segment elevation myocardial infarction
  • A finalized coronary PCI
  • Male or non-fertile female subjects ≥18 years. (Females without childbearing potential, postmenopausal women and women with a history of hysterectomy or other medical conditions that preclude pregnancy)
  • Written informed consent
  • A CCTA can be scheduled within 7 days after PCI

Exclusion criteria

Exclusion Criteria:

  • Has received influenza vaccination within 6 months
  • Other vaccination planned within 8 weeks (including covid-19 booster doses)
  • Severe allergy to eggs or previous allergic reaction to influenza vaccine
  • Cardiac surgery or staged PCI planned within 8 weeks
  • Coronary stent involving the proximal RCA
  • Suspicion of febrile illness or acute, ongoing infection
  • Hypersensitivity to the active substances or ingredients of Vaxigrip or against any residues, such as eggs (ovalbumin or chicken proteins), neomycin, formaldehyde and octoxinol
  • Subjects with endogenic or iatrogenic immunosuppression that may result in reduced immunization response
  • Inability to provide informed consent
  • Previous randomization in the ELIMINATE trial
  • Any non-cardiovascular condition, e.g. malignancy, with a life expectancy of less than 1 year based on the investigator´s clinical judgement.
  • Contraindication to coronary CT angiography (e.g., inability to lie flat, contraindication to glyceryl trinitrate, previous contrast allergy or contrast-induced nephropathy, severe renal impairment [eGFR \<30 mL/min/1.73 m2])
  • Atrial fibrillation
  • Uncontrolled chronic inflammatory disease
  • Unable to comply with protocol requirements
04

Study design

Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
90 participants (estimated)

Study arms

  • Active comparator
    Vaccination arm

    Influenza vaccine (Inactivated, split virus or surface antigen Suspension for injection, prefilled syringe ATC code: J07BB02)

    Biological: Influenza vaccine

  • Placebo comparator
    Placebo arm

    Sodium Chloride (Placebo) Solution for infusion, 9mg/ml ATC code: B05BB01

    Biological: Placebo

Interventions

  • BiologicalInfluenza vaccine

    Inactivated, split virus or surface antigen Suspension for injection, prefilled syringe ATC code: J07BB02

  • BiologicalPlacebo

    Sodium Chloride Solution for infusion, 9mg/ml ATC code: B05BB01

05

What researchers measure

Primary outcomes

  1. The right coronary artery

    Primary endpoint definition is a difference in pericoronary adipose tissue density (perivascular fat attenuation index) around the right coronary artery (RCA) measured by repeated CCTA imaging

    Time frame: Between baseline and 8 weeks follow up.

Secondary outcomes

  1. The whole coronary tree

    Change from baseline in the average pericoronary adipose tissue density of the whole coronary tree (main epicardial arteries ≥2mm).

    Time frame: Between baseline and 8 weeks follow up.

  2. Ascending aorta

    Change from baseline in the perivascular adipose tissue density of the ascending aorta

    Time frame: Between baseline and 8 weeks follow up.

  3. Interleukin 1 beta (IL-1β)

    Difference in peripheral blood IL-1β concentrations

    Time frame: Between baseline and 8 weeks follow up.

  4. Tumor necrosis factor alpha (TNF-α)

    Difference in peripheral blood TNF-α concentrations

    Time frame: Between baseline and 8 weeks follow up.

  5. Interleukin-2 receptor (IL-2r)

    Difference in peripheral blood IL-2r concentrations

    Time frame: Between baseline and 8 weeks follow up.

  6. Interleukin Interleukin-6 (IL-6 )

    Difference in peripheral blood IL-6 concentrations

    Time frame: Between baseline and 8 weeks follow up.

  7. Ferritin

    Difference in peripheral blood ferritin concentrations

    Time frame: Between baseline and 8 weeks follow up.

  8. Troponin-I

    Differences in peripheral blood troponin-I concentrations between study groups

    Time frame: At 8 weeks follow up.

  9. N-terminal pro-B-type natriuretic peptide

    Differences in peripheral blood N-terminal pro-B-type natriuretic peptide concentrations between study groups

    Time frame: At 8 weeks follow up.

Other outcomes

  1. Explorative endpoints

    Differences in peripheral blood immune cell signatures measured by mass cytometry (CyTOF), and proteomics (O-link) will be assessed in a subset of patients with and without reduction in coronary inflammation, measured by perivascular adipose tissue density on CCTA . Single cell RNA sequencing (sRNAseq) and measurements of cytokine profiles after in-vitro stimulation of peripheral blood mononuclear cells (PBMCs) will be performed in a subgroup of patients

    Time frame: 8 weeks follow up

  2. Explorative endpoints

    Exploratory proteomics by (O-link) from day 0 sampling will be performed in the whole study population to identify early biomarkers for prediction of residual inflammation.

    Time frame: Baseline

06

Study locations

3 of 3 sites recruiting
  • Aarhus University Hospital, Department of Cardiology
    Aarhus, DK-8200, Denmark
    Recruiting
  • Örebro University Hospital
    Örebro, 70185, Sweden
    Recruiting
  • Cambridge University Hospitals NHS Foundation Trust
    Cambridge, CB2 0QQ, United Kingdom
    Recruiting
07

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT06336317
Lead sponsor
Region Örebro County
Collaborators
The Swedish Heart and Lung Association, Örebro University, Sweden, University of Cambridge, Aarhus University Hospital, Cambridge University Hospitals NHS Foundation Trust
Responsible party
Sponsor
First posted
Mar 28, 2024
Start date
Apr 24, 2024
Primary completion
Dec 2027 (estimated)
Completion
Dec 2027 (estimated)
Last update
Apr 7, 2026

Study contacts

Sara Cajander, MD
Contact
sara.cajander@oru.se
+46196021042 ext. +46196021000
Sara Cajander, MD
principal investigator · Region Örebro län
Ole Frøbert, professor
study chair · Region Örebro län

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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