Vidya Navaratnam1,2, Adrian A Root3, Ian Douglas3, Liam Smeeth3, Richard B Hubbard1, Jennifer K Quint2. 1. 1 Division of Epidemiology and Public Health, University of Nottingham, Nottingham, United Kingdom. 2. 2 Department of Respiratory Epidemiology, Occupational Medicine, and Public Health, National Heart and Lung Institute, Imperial College London, United Kingdom; and. 3. 3 Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.
Abstract
RATIONALE: Studies suggest that adults with bronchiectasis are at increased risk of cardiovascular comorbidities. OBJECTIVES: We aimed to quantify the relative risk of incident cardiovascular events after a respiratory tract infection among adults with bronchiectasis. METHODS: Using UK electronic primary care records, we conducted a within-person comparison using the self-controlled case series method. We calculated the relative risk of first-time cardiovascular events (either first myocardial infarction or stroke) after a respiratory tract infection compared with the individual's baseline risk. RESULTS: Our cohort consisted of 895 adult men and women with non-cystic fibrosis bronchiectasis with a first myocardial infarction or stroke and at least one respiratory tract infection. There was an increased rate of first-time cardiovascular events in the 91-day period after a respiratory tract infection (incidence rate ratio, 1.56; 95% confidence interval, 1.20-2.02). The rate of a first cardiovascular event was highest in the first 3 days after a respiratory tract infection (incidence rate ratio, 2.73; 95% confidence interval, 1.41-5.27). CONCLUSIONS: These data suggest that respiratory tract infections are strongly associated with a transient increased risk of first-time myocardial infarction or stroke among people with bronchiectasis. As respiratory tract infections are six times more common in people with bronchiectasis than the general population, the increased risk has a disproportionately greater impact in these individuals. These findings may have implications for including cardiovascular risk modifications in airway infection treatment pathways in this population.
RATIONALE: Studies suggest that adults with bronchiectasis are at increased risk of cardiovascular comorbidities. OBJECTIVES: We aimed to quantify the relative risk of incident cardiovascular events after a respiratory tract infection among adults with bronchiectasis. METHODS: Using UK electronic primary care records, we conducted a within-person comparison using the self-controlled case series method. We calculated the relative risk of first-time cardiovascular events (either first myocardial infarction or stroke) after a respiratory tract infection compared with the individual's baseline risk. RESULTS: Our cohort consisted of 895 adult men and women with non-cystic fibrosis bronchiectasis with a first myocardial infarction or stroke and at least one respiratory tract infection. There was an increased rate of first-time cardiovascular events in the 91-day period after a respiratory tract infection (incidence rate ratio, 1.56; 95% confidence interval, 1.20-2.02). The rate of a first cardiovascular event was highest in the first 3 days after a respiratory tract infection (incidence rate ratio, 2.73; 95% confidence interval, 1.41-5.27). CONCLUSIONS: These data suggest that respiratory tract infections are strongly associated with a transient increased risk of first-time myocardial infarction or stroke among people with bronchiectasis. As respiratory tract infections are six times more common in people with bronchiectasis than the general population, the increased risk has a disproportionately greater impact in these individuals. These findings may have implications for including cardiovascular risk modifications in airway infection treatment pathways in this population.
Entities:
Keywords:
bronchiectasis; cardiovascular disease; myocardial infarction; self-controlled case series; stroke
Authors: Sara Lonni; James D Chalmers; Pieter C Goeminne; Melissa J McDonnell; Katerina Dimakou; Anthony De Soyza; Eva Polverino; Charlotte Van de Kerkhove; Robert Rutherford; John Davison; Edmundo Rosales; Alberto Pesci; Marcos I Restrepo; Antoni Torres; Stefano Aliberti Journal: Ann Am Thorac Soc Date: 2015-12
Authors: Jennifer K Quint; Elizabeth R C Millett; Miland Joshi; Vidya Navaratnam; Sara L Thomas; John R Hurst; Liam Smeeth; Jeremy S Brown Journal: Eur Respir J Date: 2015-11-05 Impact factor: 16.671
Authors: Anant R C Patel; Beverly S Kowlessar; Gavin C Donaldson; Alex J Mackay; Richa Singh; Siobhan N George; Davinder S Garcha; Jadwiga A Wedzicha; John R Hurst Journal: Am J Respir Crit Care Med Date: 2013-11-01 Impact factor: 21.405
Authors: Vidya Navaratnam; Elizabeth R C Millett; John R Hurst; Sara L Thomas; Liam Smeeth; Richard B Hubbard; Jeremy Brown; Jennifer K Quint Journal: Thorax Date: 2016-08-29 Impact factor: 9.139
Authors: Hayoung Choi; Sang Hyuk Kim; Kyungdo Han; Tai Sun Park; Dong Won Park; Ji-Yong Moon; Sang-Heon Kim; Tae-Hyung Kim; Jang Won Sohn; Ho Joo Yoon; Hyun Lee Journal: Respir Res Date: 2022-10-18