Division of Population Medicine, Cardiff University, Cardiff, UK
Population Data Science, Swansea University Medical School, Swansea, UK.
BMJ Open. 2022 Sep 22;12(9):e064586. doi: 10.1136/bmjopen-2022-064586.
There is increasing interest in the relationship between acute infections and acute cardiovascular events. Most previous research has focused on understanding whether the risk of acute cardiovascular events increases following a respiratory tract infection. The relationship between urinary tract infections (UTIs) and acute cardiovascular events is less well studied. Therefore, the aim of this study is to determine whether there is a causal relationship between UTI and acute myocardial infarction (MI) or stroke.
We will undertake a self-controlled case series study using linked anonymised general practice, hospital admission and microbiology data held within the Secure Anonymised Information Linkage (SAIL) Databank. Self-controlled case series is a relatively novel study design where individuals act as their own controls, thereby inherently controlling for time-invariant confounders. Only individuals who experience an exposure and outcome of interest are included.We will identify individuals in the SAIL Databank who have a hospital admission record for acute MI or stroke during the study period of 2010-2020. Individuals will need to be aged 30-100 during the study period and be Welsh residents for inclusion. UTI will be identified using general practice, microbiology and hospital admissions data. We will calculate the incidence of MI and stroke in predefined risk periods following an UTI and in 'baseline' periods (without UTI exposure) and use conditional Poisson regression models to derive incidence rate ratios.
Data access, research permissions and approvals have been obtained from the SAIL independent Information Governance Review Panel, project number 0972. Findings will be disseminated through conferences, blogs, social media threads and peer-reviewed journals. Results will be of interest internationally to primary and secondary care clinicians who manage UTIs and may inform future clinical trials of preventative therapy.
急性感染与急性心血管事件之间的关系日益受到关注。大多数先前的研究都集中在了解呼吸道感染后急性心血管事件的风险是否会增加。尿路感染 (UTI) 与急性心血管事件的关系研究较少。因此，本研究旨在确定 UTI 与急性心肌梗死 (MI) 或中风之间是否存在因果关系。
我们将使用链接的匿名全科医生、住院和微生物学数据，在安全匿名信息链接 (SAIL) 数据库中进行自我对照病例系列研究。自我对照病例系列研究是一种相对较新的研究设计，其中个体作为自己的对照，从而内在地控制了时间不变的混杂因素。只有经历了感兴趣的暴露和结果的个体才会被包括在内。我们将在 SAIL 数据库中确定在研究期间（2010-2020 年）有急性 MI 或中风住院记录的个体。个体在研究期间需要年龄在 30-100 岁之间，并且是威尔士居民才能被纳入。UTI 将使用全科医生、微生物学和住院数据进行识别。我们将计算 UTI 后和“基线”期（无 UTI 暴露）内 MI 和中风的发生率，并使用条件泊松回归模型得出发病率比。
数据访问、研究许可和批准已从 SAIL 独立信息治理审查小组获得，项目编号为 0972。研究结果将通过会议、博客、社交媒体线程和同行评议期刊进行传播。研究结果将在国际上引起初级和二级保健临床医生的关注，他们管理 UTI，并可能为未来的预防性治疗临床试验提供信息。
