Triggering of cardiovascular disease by infection type: The atherosclerosis risk in communities study (ARIC)
Document Type
Article
Publication Date
10-6-2020
Publication Title
International Journal of Cardiology
DOI
10.1016/j.ijcard.2020.09.073
ISSN
0167-5273
Abstract
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 UTI, 102 had pneumonia, 43 had cellulitis, and 28 had a bloodstream 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 CHD 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 UTI (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.
Recommended Citation
Cowan, Logan, Brian Buck, Jessica S. Schwind, Pamela L. Lutsey, James S. Pankow, Kunihiro Matsushita, Kamakshi Lakshminarayan.
2020.
"Triggering of cardiovascular disease by infection type: The atherosclerosis risk in communities study (ARIC)."
International Journal of Cardiology, 325 (15): 155-160: Elsevier.
doi: 10.1016/j.ijcard.2020.09.073 pmid: 33031889
https://digitalcommons.georgiasouthern.edu/bee-facpubs/241
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