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Laboratory-confirmed respiratory infections as predictors of hospital admission for myocardial infarction and stroke: time-series analysis of English data for 2004-2015

Blackburn, RM; Zhao, H; Pebody, R; Hayward, AC; Warren-Gash, C; (2018) Laboratory-confirmed respiratory infections as predictors of hospital admission for myocardial infarction and stroke: time-series analysis of English data for 2004-2015. Clinical Infectious Diseases 10.1093/cid/cix1144. Green open access

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Abstract

Background: Acute respiratory infections are associated with increased risk of myocardial infarction (MI) and stroke, however, the role of different organisms is poorly characterised. Methods: We undertook a time-series analysis of English hospital admissions for MI and stroke (age-stratified: 45-64, 65-74, 75+ years), laboratory-confirmed viral respiratory infections and environmental data for 2004-2015. Weekly counts of admissions were modelled using multivariable Poisson regression with weekly counts of respiratory viruses (influenza, parainfluenza, rhinovirus, respiratory syncytial virus (RSV), adenovirus or human meta-pneumovirus (HMPV)) investigated as predictors. We controlled for seasonality, long-term trends and environmental factors. Results: Weekly hospital admissions in adults aged 45+ years averaged 1347 (IQR 1217-1541) for MI and 1175 (IQR 1023-1395) for stroke. Median numbers of respiratory infections ranged from 11 cases per week (IQR 5-53) for influenza to 55 (IQR 7-127) for rhinovirus. In the adjusted models, all viruses except parainfluenza were significantly associated with MI and ischaemic stroke admissions in those aged 75+. Among 65-74 year olds, adenovirus, rhinovirus and RSV were associated with MI but not ischaemic stroke admissions. Respiratory infections were not associated with MI or ischaemic stroke in people aged 45-64, nor with haemorrhagic stroke in any age group. An estimated 0.4-5.7% of MI and ischaemic stroke admissions may be attributable to respiratory infection, with greater excess burden during weeks with high circulating virus levels. Conclusions: We identified small but strongly significant associations in the timing of respiratory infection (with HMPV, RSV, influenza, rhinovirus and adenovirus) and MI or ischaemic stroke hospitalisations in the elderly. Registered at Clinicaltrials.gov: NCT02984280.

Type: Article
Title: Laboratory-confirmed respiratory infections as predictors of hospital admission for myocardial infarction and stroke: time-series analysis of English data for 2004-2015
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1093/cid/cix1144
Publisher version: https://academic.oup.com/cid/advance-article/doi/1...
Language: English
Additional information: Copyright © The Author(s) 2018. Published by Oxford University Press for the Infectious Diseases Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: Epidemiology, myocardial infarction, respiratory infection, stroke
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Epidemiology and Public Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Primary Care and Population Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Health Informatics
URI: https://discovery.ucl.ac.uk/id/eprint/10042441
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