Clayton Tim C, Thompson Mary, Meade Tom W
Medical Statistics Unit, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK.
Eur Heart J. 2008 Jan;29(1):96-103. doi: 10.1093/eurheartj/ehm516. Epub 2007 Dec 6.
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.
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.
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.
呼吸道感染可能与重大心血管事件风险增加有关。本病例对照研究描述了呼吸道感染与这些事件之间的关联。
使用IMS疾病分析仪Mediplus初级保健数据库识别首次诊断为心肌梗死（MI）或中风的所有病例以及单个匹配对照。提取了前一年因呼吸道感染就诊的详细信息。共识别出11155例MI病例和9208例中风病例。对于MI和中风，在索引日期前一个月分别有326例和260例呼吸道感染。有强有力的证据表明，感染后7天内这两种事件的风险均增加，MI的调整优势比（OR）为2.10（95%置信区间1.38 - 3.21），中风的OR为1.92（95%置信区间1.24 - 2.97）。这些关联的强度随时间下降。MI的关联在所有初始潜在心血管风险水平均存在。
近期呼吸道感染与重大心血管事件之间存在密切关联，在所有潜在风险水平下MI均如此。通过免疫或治疗或预防感染来减少呼吸道感染可能带来巨大益处。
