Does Acute Infection Increase Transient Risks for MI and Stroke 
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 Does Acute Infection Increase Transient Risks for MI and Stroke




Summary and Comment

Does Acute Infection Increase Transient Risks for MI and Stroke?

Given the link between inflammation and atherosclerosis progression,
researchers hypothesized that the risks for MI and stroke might increase
after acute infection or vaccination. To test that hypothesis, they
analyzed data from about 105,000 people who experienced first MIs or
strokes at least 6 months after being registered in the U.K.'s General
Practice Research Database for 1987 to 2001.

For each patient, the first 90-day period after exposure to the
inflammatory stimulus was compared with all other observed time periods,
such that patients served as their own controls. Inflammatory stimuli were
acute urinary-tract and respiratory-tract infections, and vaccinations
against influenza, tetanus, and pneumococcus.

Vaccinations were not associated with increased risks for a first MI or a
first stroke. In contrast, risks increased significantly after acute
respiratory-tract infections, particularly within the first 3 days after
exposure (age-adjusted incidence ratios: 4.95 for MI, 3.19 for stroke). For
urinary-tract infections, age-adjusted incidence ratios for events during
the first 3 days were somewhat lower than the figures for respiratory-tract
infections, but they still were significant (1.66 for MI, 2.72 for stroke).

Comment: In this study, respiratory- and urinary-tract infections -- but
not vaccinations -- were associated with transiently increased risks for MI
and stroke. The authors believe that acute infections likely help to
trigger cardiovascular events.

-- Harlan M. Krumholz, MD, SM

Published in Journal Watch Cardiology January 28, 2005

Tue, 17 Jul 2007 06:43:22 GMT
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