Severe infections as risk factors for acute myocardial infarction: a nationwide, Danish cohort study from 1987-2018.

IF 8.4 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS European journal of preventive cardiology Pub Date : 2024-10-22 DOI:10.1093/eurjpc/zwae344
Emilie Marie Juelstorp Pedersen, Harman Yonis, Gertrud Baunbæk Egelund, Nicolai Lohse, Christian Torp-Pedersen, Birgitte Lindegaard, Andreas Vestergaard Jensen
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Abstract

Aims: Infections have been associated with acute myocardial infarction (AMI), but differences in risk between infection types and age groups are unclear. This study aims to investigate whether infections are associated with subsequent AMI and whether the risk differs across infection sites and age groups.

Methods: Nationwide registers were used to include 702596 adults hospitalized between 1987-2018 with either; pneumonia (n=344319), urinary tract infection (UTI) (n=270101), soft tissue/bone infection (n=66718), central nervous system infection (CNS) (n=17025), or endocarditis (n=4433). Patients were sex- and age-matched with two unexposed controls. Outcome was first-time AMI within ten years. A time-dependent cox proportional hazards model with cut-offs at 30 and 90 days was used for calculating adjusted hazard ratios (HR).

Results: Pneumonia, UTI, and soft tissue/bone infection were associated with increased relative rates of AMI compared to matched, unexposed controls. Highest relative rates were found within the first 0-30 days post-exposure; Pneumonia: HR 3.39 (95% CI 3.15-3.65), UTI: HR 2.44 (95% CI 2.21-2.70), Soft tissue/bone infection: HR 1.84 (95% CI 1.45-2.33). Relative rates decreased over time but remained significantly elevated throughout the follow-up period and was increased in all age groups. No association was found for CNS infection and for endocarditis only at 31-90 days, HR 2.28 (95% CI 1.20-4.33).

Conclusion: Acute infections are associated with increased relative rates of AMI across different infection sites and age groups with higher relative rates found for pneumonia. This indicates that some infections may act as a trigger for AMI with a site and/or pathogen specific risk.

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严重感染是急性心肌梗死的风险因素:1987-2018 年丹麦全国范围内的队列研究。
目的:感染与急性心肌梗死(AMI)有关,但感染类型和年龄组之间的风险差异尚不清楚。本研究旨在调查感染是否与随后发生的急性心肌梗死有关,以及不同感染部位和年龄组的风险是否存在差异:该研究使用全国性登记册,纳入了 1987-2018 年间因肺炎(n=344319)、尿路感染(UTI)(n=270101)、软组织/骨感染(n=66718)、中枢神经系统感染(CNS)(n=17025)或心内膜炎(n=4433)住院的 702596 名成人。患者的性别和年龄与两名未受感染的对照组相匹配。结果为十年内首次发生急性心肌梗死。计算调整后的危险比(HR)时,采用了以30天和90天为分界点的时间依赖性Cox比例危险模型:结果:与匹配的未暴露对照组相比,肺炎、UTI 和软组织/骨骼感染与急性心肌梗死的相对发生率增加有关。肺炎:HR 3.39 (95% CI 3.15-3.65),UTI:HR 2.44 (95% CI 2.21-2.70),软组织/骨骼感染:HR 1.84 (95% CI 3.15-3.65):HR 1.84 (95% CI 1.45-2.33)。随着时间的推移,相对比率有所下降,但在整个随访期间仍显著升高,并且在所有年龄组中都有所上升。中枢神经系统感染和心内膜炎在31-90天内没有相关性,HR为2.28(95% CI为1.20-4.33):结论:在不同感染部位和年龄组中,急性感染与急性心肌梗死的相对发生率增加有关,其中肺炎的相对发生率更高。这表明,某些感染可能是诱发急性心肌梗死的导火索,其风险与感染部位和/或病原体有关。
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来源期刊
European journal of preventive cardiology
European journal of preventive cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
12.50
自引率
12.00%
发文量
601
审稿时长
3-8 weeks
期刊介绍: European Journal of Preventive Cardiology (EJPC) is an official journal of the European Society of Cardiology (ESC) and the European Association of Preventive Cardiology (EAPC). The journal covers a wide range of scientific, clinical, and public health disciplines related to cardiovascular disease prevention, risk factor management, cardiovascular rehabilitation, population science and public health, and exercise physiology. The categories covered by the journal include classical risk factors and treatment, lifestyle risk factors, non-modifiable cardiovascular risk factors, cardiovascular conditions, concomitant pathological conditions, sport cardiology, diagnostic tests, care settings, epidemiology, pharmacology and pharmacotherapy, machine learning, and artificial intelligence.
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