tetano
Editor, Senior Moderator
Clin Infect Dis. 2018 Jan 6. doi: 10.1093/cid/cix1144. [Epub ahead of print]
[h=1]Laboratory-confirmed respiratory infections as predictors of hospital admission for myocardial infarction and stroke: time-series analysis of English data for 2004-2015.[/h] Blackburn RM[SUP]1[/SUP], Zhao H[SUP]2[/SUP], Pebody R[SUP]2[/SUP], Hayward AC[SUP]1[/SUP], Warren-Gash C[SUP]1,[/SUP][SUP]3[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]Background:[/h] Acute respiratory infections are associated with increased risk of myocardial infarction (MI) and stroke, however, the role of different organisms is poorly characterised.
[h=4]Methods:[/h] We undertook a time-series analysis of English hospital admissions for MI and stroke (age-stratified: 45-64, 65-74, 75+ years), laboratory-confirmed viral respiratory infections and environmental data for 2004-2015. Weekly counts of admissions were modelled using multivariable Poisson regression with weekly counts of respiratory viruses (influenza, parainfluenza, rhinovirus, respiratory syncytial virus (RSV), adenovirus or human meta-pneumovirus (HMPV)) investigated as predictors. We controlled for seasonality, long-term trends and environmental factors.
[h=4]Results:[/h] Weekly hospital admissions in adults aged 45+ years averaged 1347 (IQR 1217-1541) for MI and 1175 (IQR 1023-1395) for stroke. Median numbers of respiratory infections ranged from 11 cases per week (IQR 5-53) for influenza to 55 (IQR 7-127) for rhinovirus. In the adjusted models, all viruses except parainfluenza were significantly associated with MI and ischaemic stroke admissions in those aged 75+. Among 65-74 year olds, adenovirus, rhinovirus and RSV were associated with MI but not ischaemic stroke admissions. Respiratory infections were not associated with MI or ischaemic stroke in people aged 45-64, nor with haemorrhagic stroke in any age group. An estimated 0.4-5.7% of MI and ischaemic stroke admissions may be attributable to respiratory infection, with greater excess burden during weeks with high circulating virus levels.
[h=4]Conclusions:[/h] We identified small but strongly significant associations in the timing of respiratory infection (with HMPV, RSV, influenza, rhinovirus and adenovirus) and MI or ischaemic stroke hospitalisations in the elderly.
[h=4]Registered at Clinicaltrials.gov:[/h] NCT02984280.
[h=4]KEYWORDS:[/h] epidemiology; myocardial infarction; respiratory infection; stroke
[h=1]Laboratory-confirmed respiratory infections as predictors of hospital admission for myocardial infarction and stroke: time-series analysis of English data for 2004-2015.[/h] Blackburn RM[SUP]1[/SUP], Zhao H[SUP]2[/SUP], Pebody R[SUP]2[/SUP], Hayward AC[SUP]1[/SUP], Warren-Gash C[SUP]1,[/SUP][SUP]3[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]Background:[/h] Acute respiratory infections are associated with increased risk of myocardial infarction (MI) and stroke, however, the role of different organisms is poorly characterised.
[h=4]Methods:[/h] We undertook a time-series analysis of English hospital admissions for MI and stroke (age-stratified: 45-64, 65-74, 75+ years), laboratory-confirmed viral respiratory infections and environmental data for 2004-2015. Weekly counts of admissions were modelled using multivariable Poisson regression with weekly counts of respiratory viruses (influenza, parainfluenza, rhinovirus, respiratory syncytial virus (RSV), adenovirus or human meta-pneumovirus (HMPV)) investigated as predictors. We controlled for seasonality, long-term trends and environmental factors.
[h=4]Results:[/h] Weekly hospital admissions in adults aged 45+ years averaged 1347 (IQR 1217-1541) for MI and 1175 (IQR 1023-1395) for stroke. Median numbers of respiratory infections ranged from 11 cases per week (IQR 5-53) for influenza to 55 (IQR 7-127) for rhinovirus. In the adjusted models, all viruses except parainfluenza were significantly associated with MI and ischaemic stroke admissions in those aged 75+. Among 65-74 year olds, adenovirus, rhinovirus and RSV were associated with MI but not ischaemic stroke admissions. Respiratory infections were not associated with MI or ischaemic stroke in people aged 45-64, nor with haemorrhagic stroke in any age group. An estimated 0.4-5.7% of MI and ischaemic stroke admissions may be attributable to respiratory infection, with greater excess burden during weeks with high circulating virus levels.
[h=4]Conclusions:[/h] We identified small but strongly significant associations in the timing of respiratory infection (with HMPV, RSV, influenza, rhinovirus and adenovirus) and MI or ischaemic stroke hospitalisations in the elderly.
[h=4]Registered at Clinicaltrials.gov:[/h] NCT02984280.
[h=4]KEYWORDS:[/h] epidemiology; myocardial infarction; respiratory infection; stroke