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Infection as a Cardiovascular Trigger: Associations Between Different Organ System Infections and Cardiovascular Events

      Abstract

      Background

      Infection may be an acute precipitant of cardiovascular events. However, the relationships between different types of infection and cardiovascular events are less known. Our objective was to determine if exposure to infections of different organ systems in different time periods increases risk of myocardial infarction or venous thromboembolism.

      Method

      We used case-crossover analysis with conditional logistic regression to estimate odds ratios (OR) for the association for each infection type during 3 case periods (30, 60, and 90 days prior to index event) compared with control periods (exactly 1 year before).

      Results

      This study had a total number of index admissions of 338,021 individuals, of which 82,986 were female; the mean age for individuals with myocardial infarction and venous thromboembolism was 68.48 years and 62.33 years, respectively. With every infection type, there was an increased likelihood of venous thromboembolism. The greatest association was for skin infections, with an OR of 5.39 (95% confidence interval, 4.08- 7.12) within the 7-day window. The association between myocardial infarction and skin infections was of lesser magnitude, with an OR of 2.89 (confidence interval, 1.97-4.24) in the 7-day exposure period.

      Conclusion

      We found a gradient of decreasing magnitudes of association with longer time periods, across the majority of infection types and cardiovascular events. This warrants potential interventions to prevent infection or cardiovascular disease prophylaxis in individuals with infection.

      Keywords

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      Linked Article

      • Infection as a Trigger for Cardiovascular Disease
        The American Journal of MedicineVol. 133Issue 12
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          A variety of clinical infections, including the current pandemic, and a variety of physical events such as bee stings and trauma, have been documented as triggers of acute cardiovascular illness such as venous thromboembolism, myocardial infarction, and stroke.1-12 A number of factors, alone and in combination, have been proposed to explain this association between infection and acute cardiovascular disease, including activation of various inflammatory molecules and platelets, endothelial dysfunction, and augmented sympathetic nervous activity with release of high levels of catecholamines into the circulation.
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