Recent respiratory infection and risk of cardiovascular disease: case-control study through a general practice database.
OBJECTIVE
Respiratory infection may be associated with an increased risk of major cardiovascular events. This case-control study describes associations with these events of respiratory infection.


RESULTS
The IMS Disease Analyzer Mediplus primary care database was used to identify all cases of first-time diagnosis of myocardial infarction (MI) or stroke and single matched controls. Details were extracted on visits for respiratory infection over the preceding year. A total of 11 155 MI cases and 9208 stroke cases were identified. For MI and stroke respectively, there were 326 and 260 respiratory infections during the month preceding the index date. There was strong evidence of an increased risk of both events in the 7 days following infection, for MI adjusted odds ratio (OR) 2.10 (95% confidence interval 1.38-3.21), for stroke OR 1.92 (95% confidence interval 1.24-2.97). The strength of these associations fell over time. The associations for MI occurred at all levels of initial underlying cardiovascular risk.


CONCLUSIONS
There are strong associations between recent respiratory infection and major cardiovascular events, for MI at all levels of underlying risk. The benefits of reducing respiratory infection either through immunization or treating or preventing infection may be substantial.
Medical Statistics Unit, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK. tim.clayton@lshtm.ac.uk
Tim C
TC
Clayton
Mary
M
Thompson
Tom W
TW
Meade
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000382:microbiology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000382:microbiology; D012141:Respiratory Tract Infections / Q000150:complications*; D012307:Risk Factors; D020521:Stroke / Q000382:microbiology; D014552:Urinary Tract Infections / Q000150:complications*