Cardiovascular Outcomes after a Respiratory Tract Infection among Adults with Non–Cystic Fibrosis Bronchiectasis: A General Population–based Study
Open Access
- 1 March 2018
- journal article
- research article
- Published by American Thoracic Society in Annals of the American Thoracic Society
- Vol. 15 (3), 315-321
- https://doi.org/10.1513/annalsats.201706-488oc
Abstract
Rationale: Studies suggest that adults with bronchiectasis are at increased risk of cardiovascular comorbidities. Objectives: We aimed to quantify the relative risk of incident cardiovascular events after a respiratory tract infection among adults with bronchiectasis. Methods: Using UK electronic primary care records, we conducted a within-person comparison using the self-controlled case series method. We calculated the relative risk of first-time cardiovascular events (either first myocardial infarction or stroke) after a respiratory tract infection compared with the individual’s baseline risk. Results: Our cohort consisted of 895 adult men and women with non–cystic fibrosis bronchiectasis with a first myocardial infarction or stroke and at least one respiratory tract infection. There was an increased rate of first-time cardiovascular events in the 91-day period after a respiratory tract infection (incidence rate ratio, 1.56; 95% confidence interval, 1.20–2.02). The rate of a first cardiovascular event was highest in the first 3 days after a respiratory tract infection (incidence rate ratio, 2.73; 95% confidence interval, 1.41–5.27). Conclusions: These data suggest that respiratory tract infections are strongly associated with a transient increased risk of first-time myocardial infarction or stroke among people with bronchiectasis. As respiratory tract infections are six times more common in people with bronchiectasis than the general population, the increased risk has a disproportionately greater impact in these individuals. These findings may have implications for including cardiovascular risk modifications in airway infection treatment pathways in this population.Keywords
This publication has 30 references indexed in Scilit:
- Incidence of Community-Acquired Lower Respiratory Tract Infections and Pneumonia among Older Adults in the United Kingdom: A Population-Based StudyPLOS ONE, 2013
- Influenza Infection and Risk of Acute Myocardial Infarction in England and Wales: A CALIBER Self-Controlled Case Series StudyThe Journal of Infectious Diseases, 2012
- Coding, Recording and Incidence of Different Forms of Coronary Heart Disease in Primary CarePLOS ONE, 2012
- Risk of Hospitalization for Stroke Associated with Antipsychotic Use in the ElderlyDrugs & Aging, 2010
- British Thoracic Society guideline for non-CFbronchiectasisThorax, 2010
- Validation and validity of diagnoses in the General Practice Research Database: a systematic reviewBritish Journal of Clinical Pharmacology, 2009
- The methodology of self-controlled case series studiesStatistical Methods in Medical Research, 2009
- Acute respiratory tract infections: A potential trigger for the acute coronary syndromeAnnals of Medicine, 2008
- Recent respiratory infection and the risk of myocardial infarctionHeart, 2005
- Risk of Myocardial Infarction and Stroke after Acute Infection or VaccinationNew England Journal of Medicine, 2004