Infection has been proposed to be a possible risk factor for the process of atherosclerosis [1]. Influenza virus infection has been temporally associated with cardiovascular morbidity and mortality, particularly among high-risk individuals with prior cardiovascular disease [2]. Few randomized clinical trials (RCTs) have evaluated the role of influenza vaccination in patients with known cardiovascular disease and suggested a potential role for the vaccine in reducing adverse events [3–7]. However, these trials were underpowered to detect survival benefits with influenza vaccination.