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Childhood infections increase risk for premature ACS in adulthood

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Patients who developed infectious disease in childhood were more likely to have premature ACS as adults, according to data presented at Acute Cardiovascular Care 2015.

In a population-based case-control study in Makassar, Indonesia, researchers administered questionnaires to 153 adult patients who had their first ACS before age 56 years, along with 153 age- and sex-matched controls, between February 2013 and December 2014 (mean age, 47 years; 81.7% men).

The questionnaires addressed history of infection during four periods in early life: 0 to 5 years, 6 to 13 years, 14 to 17 years and 18 to 21 years. The burden of infection in early life was measured on a scale from 0 to 4 according to the history and severity of infection, with a score of 2 or higher indicating positive childhood infection.

“CVD risk factors are rising rapidly in Southeast Asia, particularly in young people,” Andriany Qanitha, a PhD candidate from the Academic Medical Centre in Amsterdam, said in a press release. “Most Indonesian CVD patients are under 56 years old and still economically productive. This very young CVD onset raises the question of whether local circumstances may play a role.”

Childhood infection was associated with increased risk for premature ACS (OR = 2.67; 95% CI, 1.47-4.83). Adjustment for diet, typical risk factors, socioeconomic status and parental history of CVD yielded similar results.

Qanitha and colleagues observed an indication of interaction between infection during childhood and risk for CVD in adulthood according to Framingham Risk Score (P = .052). The risk was significantly increased among patients with a risk score above 20% (OR = 10; 95% CI, 1.21-82.51) and between 10% and 20% (OR = 4.35; 95% CI, 1.6-11.84), but not for a score below 10%. These associations persisted after adjustment for confounders.

“Our findings may apply to other countries in Southeast Asia where infectious disease is still prevalent,” Qanitha said in the release. “Here, governments and policymakers should have a combined strategy for tackling infectious disease and [CVD]. Early-life infection may be a relatively unknown contributing factor in ACS occurrence.” – by Will Offit

Reference:

Qanitha A, et al. Abstract P129. Presented at: Acute Cardiovascular Care; Oct. 17-19, 2015; Vienna.

Disclosure: Qanitha and colleagues report no relevant financial disclosures.