Influenza-like illness associated with arterial dissection risk
Influenza-like illness was associated with increased risk for arterial dissections in the aorta, the cervical and coronary arteries, according to a study published in Stroke.
“We found that emergency department visits and hospitalizations for influenza-like illness were associated with an increased short-term risk for arterial dissections in the aorta, the cervical and coronary arteries,” Jens Witsch, MD, assistant professor of neurology at the Hospital of the University of Pennsylvania, and colleagues wrote.
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In a crossover-cohort analysis of administrative claims data from all hospitalizations and ED visits in New York from 2006 to 2016 and in Florida from 2005 to 2018, the researchers found that of 18,561,671 patients, 24% (mean age, 42 years; 62% women) went to the ED or were hospitalized with influenza-like illness (ILI). Of the patients with ILI, 0.014% had aortic, cervical, or coronary dissections within 180 days of their ILI diagnosis.
Witsch and colleagues found that the absolute increase in all arterial dissections was 0.3 (95% CI, 0.2-0.4) per 10,000 patients during a period of 1 to 30 days following the ILI exposure, representing a significant increase over the corresponding period 1 year later (OR = 2.21; 95% CI, 1.75-2.82). Increased risk for arterial dissection was not observed in subsequent 30-day periods.
A significant increase in risk was found across aortic (OR = 1.99; 95% CI, 1.5-2.66; P < .001), cervical (OR = 3.19; 95% CI, 1.79-5.99; P < .001) and coronary (OR = 2.42; 95% CI, 1.2-5.2; P = .012) dissection subtypes within 30 days of ILI exposure.
“Our data support prior findings highlighting a similar timeframe of an increased risk of cervical dissection after ILI,” Witsch and colleagues wrote. “Our study is novel in that we found that the increased risk of dissection after ILI pertains not only to the cervical arteries but extends to other vascular beds. This suggests a short-term systemically elevated dissection risk after ILI.”
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