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Respiratory infections may trigger acute MI
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Researchers from University College London have suggested that influenza and other respiratory infections may trigger acute myocardial infarctions.
According to the researchers, who reported in the Journal of Infectious Diseases, there is evidence of an association between influenza and cardiovascular mortality, but the specific role of influenza as a trigger for MI is not clear. If such an association was confirmed, it would further increase support for influenza vaccination among high-risk adults.
The researchers conducted a self-controlled case series analysis by identifying cases of first acute MI using linked data from General Practice Research Database (GPRD) and the Myocardial Ischaemia National Audit Project (MINAP). The electronic medical records include data on more than 5 million patients throughout the United Kingdom.
From 2003 to July 31, 2009, there were 22,024 patients identified with acute coronary syndrome, and of these, 11,208 experienced their first acute MI at age 40 years or older. Among those, 3,927 were also treated for acute respiratory infection.
The risk for acute MI was higher within the first 3 days after acute respiratory infection, with an incidence ratio of 4.19 (95% CI, 3.18-5.53). Elderly patients had the highest risk, with an incidence ratio of 5.94 (95% CI, 3.90-9.04) among those aged at least 80 years. In addition, the risk for acute MI was higher during peak weeks of influenza virus circulation.
“This study adds to the evidence to support increased efforts to maximize uptake of influenza vaccination in these groups to protect against cardiovascular complications of influenza,” the researchers wrote. “Our analysis was restricted to first acute myocardial infarction events. People who had these would not necessarily fall under the vaccination guidelines as people with established cardiac disease. This is a potential argument for lowering the age limit for routine influenza vaccination (currently 65 years in the United Kingdom).”
Disclosure: One researcher has served as a consultant to GlaxoSmithKline.
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