Announcement

Collapse
No announcement yet.

Eur. Resp.J. Laboratory-confirmed respiratory infections as triggers for acute myocardial infarction and stroke: a self-controlled case series analysis of national linked datasets from Scotland

Collapse
X
 
  • Filter
  • Time
  • Show
Clear All
new posts

  • Eur. Resp.J. Laboratory-confirmed respiratory infections as triggers for acute myocardial infarction and stroke: a self-controlled case series analysis of national linked datasets from Scotland

    Laboratory-confirmed respiratory infections as triggers for acute myocardial infarction and stroke: a self-controlled case series analysis of national linked datasets from Scotland

    Charlotte Warren-Gash, Ruth Blackburn, Heather Whitaker, Jim McMenamin, Andrew C. Hayward
    European Respiratory Journal 2018; DOI: 10.1183/13993003.01794-2017




    Abstract

    While acute respiratory infections can trigger cardiovascular events, the differential effect of specific organisms is unknown. This is important to guide vaccine policy.
    Using national infection surveillance data linked to the Scottish Morbidity Record, we identified adults with a first myocardial infarction (MI) or stroke from 01/01/2004 to 31/12/2014 and a record of laboratory-confirmed respiratory infection during this period. Using self-controlled case series analysis, we generated age- and season-adjusted incidence ratios (IR) for MI (n=1,227) or stroke (n=762) after infections compared to baseline time.
    We found substantially increased MI rates in the week after S.pneumoniae and influenza: adjusted IRs for days 1?3 were 5.98, 95% CI 2.47?14.4, and 9.80, 95% CI 2.7?40.5, respectively. Rates of stroke after infection were similarly high and remained elevated to 28 days: day 1?3 adjusted IRs 12.3, 95% CI 5.48?27.7, and 7.82, 95% CI 1.07?56.9, for S.pneumoniae and influenza. Although other respiratory viruses were associated with raised point estimates for both outcomes, only the day 4?7 estimate for stroke reached statistical significance.
    We showed a marked cardiovascular triggering effect of S.pneumoniae and influenza, which highlights the need for adequate pneumococcal and influenza vaccine uptake. Further research is needed into vascular effects of non-influenza respiratory viruses.

    While acute respiratory infections can trigger cardiovascular events, the differential effect of specific organisms is unknown. This is important to guide vaccine policy. Using national infection surveillance data linked to the Scottish Morbidity Record, we identified adults with a first myocardial infarction (MI) or stroke from 01/01/2004 to 31/12/2014 and a record of laboratory-confirmed respiratory infection during this period. Using self-controlled case series analysis, we generated age- and season-adjusted incidence ratios (IR) for MI (n=1,227) or stroke (n=762) after infections compared to baseline time. We found substantially increased MI rates in the week after S.pneumoniae and influenza: adjusted IRs for days 1–3 were 5.98, 95% CI 2.47–14.4, and 9.80, 95% CI 2.7–40.5, respectively. Rates of stroke after infection were similarly high and remained elevated to 28 days: day 1–3 adjusted IRs 12.3, 95% CI 5.48–27.7, and 7.82, 95% CI 1.07–56.9, for S.pneumoniae and influenza. Although other respiratory viruses were associated with raised point estimates for both outcomes, only the day 4–7 estimate for stroke reached statistical significance. We showed a marked cardiovascular triggering effect of S.pneumoniae and influenza, which highlights the need for adequate pneumococcal and influenza vaccine uptake. Further research is needed into vascular effects of non-influenza respiratory viruses. Laboratory-confirmed respiratory infections are linked to strokes and heart attacks in a Scottish population Footnotes This manuscript has recently been accepted for publication in the European Respiratory Journal . It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article. Conflict of interest: Dr. Warren-Gash has nothing to disclose. Conflict of interest: Dr. Blackburn has nothing to disclose. Conflict of interest: Dr. Whitaker reports grants from MRC, grants from IMI / EFPIA, outside the submitted work. Conflict of interest: Dr. McMenamin has nothing to disclose. Conflict of interest: Dr. Hayward has nothing to disclose.


Working...
X