tetano
Editor, Senior Moderator
[h=1]Laboratory-confirmed respiratory infections as triggers for acute myocardial infarction and stroke: a self-controlled case series analysis of national linked datasets from Scotland[/h] Charlotte Warren-Gash, Ruth Blackburn, Heather Whitaker, Jim McMenamin, Andrew C. Hayward
European Respiratory Journal 2018; DOI: 10.1183/13993003.01794-2017
[h=2]Abstract[/h] 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.
http://erj.ersjournals.com/content/early/2018/02/15/13993003.01794-2017
European Respiratory Journal 2018; DOI: 10.1183/13993003.01794-2017
[h=2]Abstract[/h] 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.
http://erj.ersjournals.com/content/early/2018/02/15/13993003.01794-2017