Farr Institute of Health Informatics Research, University College London.
National Infection Service Colindale, Public Health England.
Clin Infect Dis. 2018 Jun 18;67(1):8-17. doi: 10.1093/cid/cix1144.
Acute respiratory infections are associated with increased risk of myocardial infarction (MI) and stroke; however, the role of different organisms is poorly characterized.
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 modeled using multivariable Poisson regression with weekly counts of respiratory viruses (influenza, parainfluenza, rhinovirus, respiratory syncytial virus [RSV], adenovirus, or human metapneumovirus [HMPV]) investigated as predictors. We controlled for seasonality, long-term trends, and environmental factors.
Weekly hospital admissions in adults aged ≥45 years averaged 1347 (interquartile range [IQR], 1217-1541) for MI and 1175 (IQR, 1023-1395) for stroke. 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 ischemic stroke admissions in those aged ≥75. Among 65- to 74-year-olds, adenovirus, rhinovirus, and RSV were associated with MI but not ischemic stroke admissions. Respiratory infections were not associated with MI or ischemic stroke in people aged 45-64 years, nor with hemorrhagic stroke in any age group. An estimated 0.4%-5.7% of MI and ischemic stroke admissions may be attributable to respiratory infection.
We identified small but strongly significant associations in the timing of respiratory infection (with HMPV, RSV, influenza, rhinovirus, and adenovirus) and MI or ischemic stroke hospitalizations in the elderly.
NCT02984280.
急性呼吸道感染与心肌梗死（MI）和中风的风险增加有关；然而，不同病原体的作用尚未得到充分描述。
对 2004 年至 2015 年期间，英国 MI 和中风（年龄分层：45-64、65-74、≥75 岁）住院患者、实验室确诊的病毒呼吸道感染和环境数据进行时间序列分析。采用多变量泊松回归模型对每周住院人数进行建模，以呼吸道病毒（流感、副流感、鼻病毒、呼吸道合胞病毒 [RSV]、腺病毒或人类偏肺病毒 [HMPV]）的每周计数作为预测指标。我们控制了季节性、长期趋势和环境因素。
≥45 岁成年人每周平均 MI 住院人数为 1347 例（四分位距 [IQR]，1217-1541），每周平均中风住院人数为 1175 例（IQR，1023-1395）。呼吸道感染每周范围从流感 11 例（IQR，5-53）到鼻病毒 55 例（IQR，7-127）。在调整后的模型中，除副流感外，所有病毒均与≥75 岁人群的 MI 和缺血性中风住院相关。在 65-74 岁人群中，腺病毒、鼻病毒和 RSV 与 MI 相关，但与缺血性中风住院无关。呼吸道感染与 45-64 岁人群的 MI 或缺血性中风无关，也与任何年龄组的出血性中风无关。估计有 0.4%-5.7%的 MI 和缺血性中风住院可归因于呼吸道感染。
我们在老年人的呼吸道感染（HMPV、RSV、流感、鼻病毒和腺病毒）与 MI 或缺血性中风住院的时间上发现了小但具有统计学意义的关联。
NCT02984280。
