In the Journals

Risk for MI, stroke increases after respiratory infection

Patients who developed influenza or pneumonia had an increased risk for MI or stroke after the infection, according to a study published in the European Respiratory Journal.

“Heart disease, strokes and lower respiratory infections have been the three leading causes of death globally for over 15 years and are important public health problems that affect large numbers of people worldwide,” Charlotte Warren-Gash, MRCP, PhD, associate professor of epidemiology at the London School of Hygiene and Tropical Medicine in the United Kingdom, said in a press release. “As people age, having more than one medical condition becomes more common, so it is even more important to understand the links between different diseases.”

Researchers analyzed hospital inpatient data of patients (median age, 68 years) from the Scottish Morbidity Record, which included clinical data, sociodemographic details, procedures and administrative information. Patients had an MI (n = 1,227; 61% men) or stroke (n = 762; 51% men) after their diagnosis of a respiratory infection was confirmed between 2004 and 2014. Respiratory infections included influenza, rhinovirus, parainfluenza, human metapneumovirus, respiratory syncytial virus and Streptococcus pneumoniae.

The exposure period was divided into days after acute respiratory infection: 1 to 3 days, 4 to 7 days, 8 to 14 days and 15 to 28 days.

After adjusting for age and season, the incidence ratio for first MI increased in the first 1 to 3 days after pneumonia (adjusted incidence ratio [aIR] = 5.98; 95% CI, 2.47-14.4) and influenza (aIR = 9.8; 95% CI, 2.37-40.5). This was also seen in patients with stroke after influenza (aIR = 7.82; 95% CI, 1.07-56.9) and pneumonia (aIR = 12.3; 95% CI, 5.48-27.7).

The incidence of stroke for other respiratory viruses reached statistical significance between days 4 and 7.

“The finding that other respiratory viruses for which vaccines are not available also act as cardiovascular triggers merits further exploration,” Warren-Gash and colleagues wrote. “It potentially strengthens the case for considering antithrombotic strategies during acute respiratory infections for vulnerable groups, especially as recent evidence points to a dual effect of acute respiratory infections and symptomatic nonsteroidal anti-inflammatory drug treatment on cardiovascular risk. Future research should focus on informing development and delivery of stratified interventions to reduce vascular risk associated with a range of respiratory organisms.” – by Darlene Dobkowski

Disclosures: The authors report no relevant financial disclosures.

Patients who developed influenza or pneumonia had an increased risk for MI or stroke after the infection, according to a study published in the European Respiratory Journal.

“Heart disease, strokes and lower respiratory infections have been the three leading causes of death globally for over 15 years and are important public health problems that affect large numbers of people worldwide,” Charlotte Warren-Gash, MRCP, PhD, associate professor of epidemiology at the London School of Hygiene and Tropical Medicine in the United Kingdom, said in a press release. “As people age, having more than one medical condition becomes more common, so it is even more important to understand the links between different diseases.”

Researchers analyzed hospital inpatient data of patients (median age, 68 years) from the Scottish Morbidity Record, which included clinical data, sociodemographic details, procedures and administrative information. Patients had an MI (n = 1,227; 61% men) or stroke (n = 762; 51% men) after their diagnosis of a respiratory infection was confirmed between 2004 and 2014. Respiratory infections included influenza, rhinovirus, parainfluenza, human metapneumovirus, respiratory syncytial virus and Streptococcus pneumoniae.

The exposure period was divided into days after acute respiratory infection: 1 to 3 days, 4 to 7 days, 8 to 14 days and 15 to 28 days.

After adjusting for age and season, the incidence ratio for first MI increased in the first 1 to 3 days after pneumonia (adjusted incidence ratio [aIR] = 5.98; 95% CI, 2.47-14.4) and influenza (aIR = 9.8; 95% CI, 2.37-40.5). This was also seen in patients with stroke after influenza (aIR = 7.82; 95% CI, 1.07-56.9) and pneumonia (aIR = 12.3; 95% CI, 5.48-27.7).

The incidence of stroke for other respiratory viruses reached statistical significance between days 4 and 7.

“The finding that other respiratory viruses for which vaccines are not available also act as cardiovascular triggers merits further exploration,” Warren-Gash and colleagues wrote. “It potentially strengthens the case for considering antithrombotic strategies during acute respiratory infections for vulnerable groups, especially as recent evidence points to a dual effect of acute respiratory infections and symptomatic nonsteroidal anti-inflammatory drug treatment on cardiovascular risk. Future research should focus on informing development and delivery of stratified interventions to reduce vascular risk associated with a range of respiratory organisms.” – by Darlene Dobkowski

Disclosures: The authors report no relevant financial disclosures.

    See more from Myocardial Infarction Resource Center