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Observational Study
. 2020 Apr;25(17):1900199.
doi: 10.2807/1560-7917.ES.2020.25.17.1900199.

Acute myocardial infarctions and stroke triggered by laboratory-confirmed respiratory infections in Denmark, 2010 to 2016

Jessica Ohland  1 , Charlotte Warren-Gash  2 , Ruth Blackburn  3 , Kåre Mølbak  1   4 , Palle Valentiner-Branth  1 , Jens Nielsen  1 , Hanne-Dorthe Emborg  1
Affiliations
Observational Study

Acute myocardial infarctions and stroke triggered by laboratory-confirmed respiratory infections in Denmark, 2010 to 2016

Jessica Ohland et al. Euro Surveill. 2020 Apr.

Abstract

BackgroundSeveral studies have investigated a possible association between respiratory infection and acute myocardial infarction (MI). As both influenza and pneumococcal infections are vaccine preventable, understanding the populations affected by virus-induced cardiovascular complications is important to guide public health and clinical practice.AimThis observational study aimed to quantify the association between laboratory-confirmed respiratory bacteria or virus infections and risk of first MI or stroke, by using self-controlled case series (SCCS) analysis of anonymised linked electronic Danish health records.MethodsThe SCCS method was used to determine the relative incidence of the first event of MI and stroke occurring within 28 days after laboratory-confirmed respiratory infections compared with the baseline time period.ResultsIn the age and season adjusted analyses for first acute MI, the incidence ratios (IR) of a MI event occurring during the risk period were significantly elevated following a Streptococcus pneumoniae infection with values of 20.1, 11.0 and 4.9 during 1-3, 4-7 and 8-14 days, respectively and following respiratory virus infection with values of 15.2, 4.5 and 4.4 during 1-3, 8-14 and 15-28 days, respectively. The significantly elevated IRs for stroke following an S. pneumoniae infection were 25.5 and 6.3 during 1-3 and 8-14 days, respectively and following respiratory virus infection 8.3, 7.8 and 6.2 during 1-3, 4-7 and 8-14 days, respectively.ConclusionThis study suggested a significant cardiovascular event triggering effect following infection with S. pneumoniae and respiratory viruses (mainly influenza), indicating the importance of protection against vaccine-preventable respiratory infections.

Keywords: acute myocardial infarction; ischemic stroke; respiratory infections self-controlled case series method.

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Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure 1
Figure 1
Illustration of the self-controlled case series study methoda used in the study, Denmark, 1 January 2010−31 December 2016
Figure 2
Figure 2
Individuals included in the study, Denmark, 1 January 2010–31 December 2016 (n = 1,350 individuals)
See this image and copyright information in PMC

References

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