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. 2018 Mar;15(3):315-321.
doi: 10.1513/AnnalsATS.201706-488OC.

Cardiovascular Outcomes after a Respiratory Tract Infection among Adults with Non-Cystic Fibrosis Bronchiectasis: A General Population-based Study

Vidya Navaratnam  1   2 , Adrian A Root  3 , Ian Douglas  3 , Liam Smeeth  3 , Richard B Hubbard  1 , Jennifer K Quint  2
Affiliations

Cardiovascular Outcomes after a Respiratory Tract Infection among Adults with Non-Cystic Fibrosis Bronchiectasis: A General Population-based Study

Vidya Navaratnam et al. Ann Am Thorac Soc. 2018 Mar.

Abstract

Rationale: Studies suggest that adults with bronchiectasis are at increased risk of cardiovascular comorbidities.

Objectives: We aimed to quantify the relative risk of incident cardiovascular events after a respiratory tract infection among adults with bronchiectasis.

Methods: Using UK electronic primary care records, we conducted a within-person comparison using the self-controlled case series method. We calculated the relative risk of first-time cardiovascular events (either first myocardial infarction or stroke) after a respiratory tract infection compared with the individual's baseline risk.

Results: Our cohort consisted of 895 adult men and women with non-cystic fibrosis bronchiectasis with a first myocardial infarction or stroke and at least one respiratory tract infection. There was an increased rate of first-time cardiovascular events in the 91-day period after a respiratory tract infection (incidence rate ratio, 1.56; 95% confidence interval, 1.20-2.02). The rate of a first cardiovascular event was highest in the first 3 days after a respiratory tract infection (incidence rate ratio, 2.73; 95% confidence interval, 1.41-5.27).

Conclusions: These data suggest that respiratory tract infections are strongly associated with a transient increased risk of first-time myocardial infarction or stroke among people with bronchiectasis. As respiratory tract infections are six times more common in people with bronchiectasis than the general population, the increased risk has a disproportionately greater impact in these individuals. These findings may have implications for including cardiovascular risk modifications in airway infection treatment pathways in this population.

Keywords: bronchiectasis; cardiovascular disease; myocardial infarction; self-controlled case series; stroke.

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Figures

Figure 1.
Figure 1.
Identification of study population.
Figure 2.
Figure 2.
Pictorial representation of the self-controlled case series. MI, myocardial infarction.
See this image and copyright information in PMC

Comment in

References

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