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丹麦 2010 至 2016 年因实验室确诊的呼吸道感染引发的急性心肌梗死和中风。

Acute myocardial infarctions and stroke triggered by laboratory-confirmed respiratory infections in Denmark, 2010 to 2016.

机构信息

Statens Serum Institut, Copenhagen, Denmark.

Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom.

出版信息

Euro Surveill. 2020 Apr;25(17). doi: 10.2807/1560-7917.ES.2020.25.17.1900199.

Abstract

BackgroundSeveral studies have investigated a possible association between respiratory infection and acute myocardial infarction (MI). As both influenza and pneumococcal infections are vaccine preventable, understanding the populations affected by virus-induced cardiovascular complications is important to guide public health and clinical practice.AimThis observational study aimed to quantify the association between laboratory-confirmed respiratory bacteria or virus infections and risk of first MI or stroke, by using self-controlled case series (SCCS) analysis of anonymised linked electronic Danish health records.MethodsThe SCCS method was used to determine the relative incidence of the first event of MI and stroke occurring within 28 days after laboratory-confirmed respiratory infections compared with the baseline time period.ResultsIn the age and season adjusted analyses for first acute MI, the incidence ratios (IR) of a MI event occurring during the risk period were significantly elevated following a infection with values of 20.1, 11.0 and 4.9 during 1-3, 4-7 and 8-14 days, respectively and following respiratory virus infection with values of 15.2, 4.5 and 4.4 during 1-3, 8-14 and 15-28 days, respectively. The significantly elevated IRs for stroke following an infection were 25.5 and 6.3 during 1-3 and 8-14 days, respectively and following respiratory virus infection 8.3, 7.8 and 6.2 during 1-3, 4-7 and 8-14 days, respectively.ConclusionThis study suggested a significant cardiovascular event triggering effect following infection with and respiratory viruses (mainly influenza), indicating the importance of protection against vaccine-preventable respiratory infections.

摘要

背景

已有多项研究调查了呼吸道感染与急性心肌梗死(MI)之间的可能关联。由于流感和肺炎球菌感染都可通过疫苗预防,了解受病毒引起的心血管并发症影响的人群对于指导公共卫生和临床实践非常重要。

目的

本观察性研究旨在通过对匿名的丹麦电子健康记录进行病例对照系列研究(SCCS)分析,量化实验室确诊的呼吸道细菌或病毒感染与首次 MI 或中风风险之间的关联。

方法

SCCS 方法用于确定与基线时间相比,实验室确诊的呼吸道感染后 28 天内首次发生 MI 和中风的相对发病率(IR)。

结果

在调整年龄和季节后,对于首次急性 MI,发生 MI 事件的风险期内的 IR 在 感染后分别为 20.1、11.0 和 4.9,在 1-3、4-7 和 8-14 天;呼吸道病毒感染后分别为 15.2、4.5 和 4.4,在 1-3、8-14 和 15-28 天。 感染后中风的 IR 显著升高,分别为 1-3 和 8-14 天的 25.5 和 6.3,以及呼吸道病毒感染的 8.3、7.8 和 6.2,分别在 1-3、4-7 和 8-14 天。

结论

本研究表明,感染 和呼吸道病毒(主要是流感)后会对心血管事件产生明显的触发作用,这表明预防可通过疫苗预防的呼吸道感染的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/38e6/7201950/825dcfc59069/1900199-f1.jpg

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