Triggering of cardiovascular disease by infection type: The Atherosclerosis Risk in Communities study (ARIC)

INTERNATIONAL JOURNAL OF CARDIOLOGY

卷:325

Article

Cowan, Logan T.¹  Buck, Brian¹  Schwind, Jessica S.¹  Lutsey, Pamela L.²  Pankow, James S.²  Matsushita, Kunihiro³  Ishigami, Junichi³  Lakshminarayan, Kamakshi² 

[1] Georgia Southern Univ, Dept Biostat Epidemiol & Environm Hlth Sci, POB 7989, Statesboro, GA 30460 USA

[2] Univ Minnesota, Div Epidemiol & Community Hlth, 300 West Bank Off Bldg 1300 S 2nd St, Minneapolis, MN 55454 USA

[3] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Epidemiol, 2024 E Monument St,Suite 2-600, Baltimore, MD 21287 USA

关键词: Coronary heart disease;    Stroke;    Infection;    Trigger;    Crossover design;    Epidemiology;   

DOI  :  10.1016/j.ijcard.2020.09.073

来源: Elsevier

【 摘 要 】

Introduction: Acute infections are known triggers of cardiovascular disease (CVD) but how this association varies across infection types is unknown. We hypothesized while acute infections increase CVD risk, the strength of this association varies across infection types. Method: Acute coronary heart disease (CHD) and ischemic stroke cases were identified in the Atherosclerosis Risk in Communities Study (ARIC). ICD-9 codes from Medicare claims were used to identify cellulitis, pneumonia, urinary tract infections (UTI), and bloodstream infections. A case-crossover design and conditional logistic regression were used to compare infection types among acute CHD and stroke cases 14, 30, 42, and 90 days before the event with two corresponding control periods (1 and 2 years prior). Results: Of the 1312 acute CHD cases, 116 had a U11, 102 had pneumonia, 43 had cellulitis, and 28 had a blood-stream infection 90 days before the CHD event. Pneumonia (OR = 25.53 (9.21,70.78)), UTI (OR = 3.32 (1.93, 5.71)), bloodstream infections (OR = 5.93 (2.07, 17.00)), and cellulitis (OR = 2.58 (1.09, 6.13)) were associated with higher acute CI-ED risk within 14 days of infection. Of the 727 ischemic stroke cases, 12 had cellulitis, 27 had pneumonia, 56 had a UTI, and 5 had a bloodstream infection within 90 days of the stroke. Pneumonia (OR = 5.59 (1.77, 17.67)) and um (OR = 3.16 (1.68,5.94)) were associated with higher stroke risk within 14 days of infection. Conclusions: Patients with pneumonia. UTI, or bloodstream infection appear to be at a 2.5 to 25.5 fold elevated CVD risk following infection. Preventive therapies during this high-risk period should be considered. (C) 2020 Elsevier B.V. All rights reserved.

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