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Coronary and Cerebrovascular Events and Exacerbation of Existing Conditions After Laboratory-Confirmed Influenza

Caroline Korves1, Nabin Neupane1, Jeremy Smith1

  • 1Clinical Epidemiology Program, Veterans Affairs Medical Center, White River Junction, Vermont, USA.

Influenza and Other Respiratory Viruses
|June 7, 2024
PubMed

Insights

Lab-confirmed influenza (LCI) significantly increases the risk of hospitalization for non-ST-elevation myocardial infarction (NSTEMI) and stroke. Influenza also exacerbates underlying respiratory and heart conditions.

Area of Science:

  • Cardiovascular Medicine
  • Infectious Diseases
  • Epidemiology

Background:

  • Influenza infection is recognized as a potential trigger for acute cardiovascular and cerebrovascular events.
  • Underlying chronic conditions may be exacerbated by influenza, leading to adverse health outcomes.

Purpose of the Study:

  • To investigate the association between lab-confirmed influenza (LCI) and the risk of coronary/cerebrovascular events.
  • To examine the impact of LCI on the exacerbation of pre-existing conditions.

Main Methods:

  • Utilized a self-controlled case series (SCCS) design analyzing data from US Veterans (≥18 years) from 2010-2018.
  • Estimated incidence ratios (IR) comparing the risk interval (0-7 days post-LCI) to control intervals.
  • Incorporated biomarker data (WBC, platelets) for mediation analysis.

Main Results:

  • Significant associations observed between LCI and hospitalization for NSTEMI (IR 7.3), ischemic stroke (IR 4.0), and hemorrhagic stroke (IR 6.2).
  • Increased IR for NSTEMI and ischemic stroke noted in individuals aged ≥65 years.
  • LCI was linked to exacerbations of asthma, COPD, and CHF.

Conclusions:

  • Lab-confirmed influenza is significantly associated with hospitalization for NSTEMI, ischemic stroke, and hemorrhagic stroke.
  • The observed association with hemorrhagic stroke may be influenced by unmeasured time-varying confounders in the SCCS design.
  • Influenza poses a substantial risk for acute cardiovascular events and exacerbation of chronic diseases.
Abstract

Keywords:
AMIVeteranscerebrovascularcoronaryinfluenzastroke

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