PDF(Pubmed)
Abstract：
While acute respiratory tract infections can trigger cardiovascular events, the differential effect of specific organisms is unknown. This is important to guide vaccine policy.Using national infection surveillance data linked to the Scottish Morbidity Record, we identified adults with a first myocardial infarction or stroke from January 1, 2004 to December 31, 2014 and a record of laboratory-confirmed respiratory infection during this period. Using self-controlled case series analysis, we generated age- and season-adjusted incidence ratios (IRs) for myocardial infarction (n=1227) or stroke (n=762) after infections compared with baseline time.We found substantially increased myocardial infarction rates in the week after Streptococcus pneumoniae and influenza virus infection: adjusted IRs for days 1-3 were 5.98 (95% CI 2.47-14.4) and 9.80 (95% CI 2.37-40.5), respectively. Rates of stroke after infection were similarly high and remained elevated to 28 days: day 1-3 adjusted IRs 12.3 (95% CI 5.48-27.7) and 7.82 (95% CI 1.07-56.9) for S. pneumoniae and influenza virus, respectively. Although other respiratory viruses were associated with raised point estimates for both outcomes, only the day 4-7 estimate for stroke reached statistical significance.We showed a marked cardiovascular triggering effect of S. pneumoniae and influenza virus, which highlights the need for adequate pneumococcal and influenza vaccine uptake. Further research is needed into vascular effects of noninfluenza respiratory viruses.
摘要：
虽然急性呼吸道感染可引发心血管事件，特定生物的差异效应是未知的。这对指导疫苗政策具有重要意义。使用与苏格兰发病率记录相关的国家感染监测数据，我们确定了2004年1月1日至2014年12月31日首次发生心肌梗死或卒中的成年人,并记录了在此期间实验室确诊的呼吸道感染.使用自控案例系列分析，我们得出了与基线时间相比,感染后心肌梗死(n=1227)或卒中(n=762)的年龄和季节校正发生率(IRs).我们发现肺炎链球菌和流感病毒感染后一周的心肌梗死率显著增加：第1-3天调整后的IRs分别为5.98（95％CI2.47-14.4）和9.80（95％CI2.37-40.5），分别。感染后的卒中发生率同样高，并持续升高至28天：肺炎链球菌和流感病毒第1-3天调整IRs12.3（95％CI5.48-27.7）和7.82（95％CI1.07-56.9），分别。尽管其他呼吸道病毒与这两种结果的点估计值升高有关，仅第4-7天的卒中估计值达到统计学意义.我们显示了肺炎链球菌和流感病毒的明显心血管触发作用，这突出了足够的肺炎球菌和流感疫苗摄取的需要。需要进一步研究非流感呼吸道病毒的血管效应。
