Cardiovascular outcomes following a respiratory tract infection among adults with non-CF bronchiectasis: a general population based study

Rationale: Studies suggest that people with bronchiectasis are at increased risk of cardiovascular co-morbidities. Objectives: We aimed to quantify the relative risk of incident cardiovascular events following a respiratory tract infection amongst people with bronchiectasis. Methods: Using U...

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Main Authors: Navaratnam, Vidya, Root, Adrian A, Douglas, Ian, Smeeth, Liam, Hubbard, Richard B., Quint, Jennifer K.
Format: Article
Language:English
Published: American Thoracic Society 2018
Subjects:
Online Access:https://eprints.nottingham.ac.uk/49007/
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author Navaratnam, Vidya
Root, Adrian A
Douglas, Ian
Smeeth, Liam
Hubbard, Richard B.
Quint, Jennifer K.
author_facet Navaratnam, Vidya
Root, Adrian A
Douglas, Ian
Smeeth, Liam
Hubbard, Richard B.
Quint, Jennifer K.
author_sort Navaratnam, Vidya
building Nottingham Research Data Repository
collection Online Access
description Rationale: Studies suggest that people with bronchiectasis are at increased risk of cardiovascular co-morbidities. Objectives: We aimed to quantify the relative risk of incident cardiovascular events following a respiratory tract infection amongst people 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 [MI] or stroke) following a respiratory tract infection compared with the individual’s baseline risk. Results: Our cohort consisted of 895 individuals with non-CF bronchiectasis with a first MI 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 [IRR] 1.56; 95% CI 1.20 to 2.02). The rate of a first cardiovascular event was highest in the first three days following a respiratory tract infection (IRR 2.73, 95% CI 1.41 to 5.27). Conclusions: These data suggest that respiratory tract infections are strongly associated with a transient increased risk of first time MI or stroke amongst 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.
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spelling nottingham-490072018-03-14T09:26:34Z https://eprints.nottingham.ac.uk/49007/ Cardiovascular outcomes following a respiratory tract infection among adults with non-CF bronchiectasis: a general population based study Navaratnam, Vidya Root, Adrian A Douglas, Ian Smeeth, Liam Hubbard, Richard B. Quint, Jennifer K. Rationale: Studies suggest that people with bronchiectasis are at increased risk of cardiovascular co-morbidities. Objectives: We aimed to quantify the relative risk of incident cardiovascular events following a respiratory tract infection amongst people 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 [MI] or stroke) following a respiratory tract infection compared with the individual’s baseline risk. Results: Our cohort consisted of 895 individuals with non-CF bronchiectasis with a first MI 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 [IRR] 1.56; 95% CI 1.20 to 2.02). The rate of a first cardiovascular event was highest in the first three days following a respiratory tract infection (IRR 2.73, 95% CI 1.41 to 5.27). Conclusions: These data suggest that respiratory tract infections are strongly associated with a transient increased risk of first time MI or stroke amongst 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. American Thoracic Society 2018-03-01 Article PeerReviewed application/pdf en https://eprints.nottingham.ac.uk/49007/1/sccs_submitted_revised_clean.pdf Navaratnam, Vidya, Root, Adrian A, Douglas, Ian, Smeeth, Liam, Hubbard, Richard B. and Quint, Jennifer K. (2018) Cardiovascular outcomes following a respiratory tract infection among adults with non-CF bronchiectasis: a general population based study. Annals of the American Thoracic Society, 15 (3). pp. 315-321. ISSN 2325-6621 Bronchiectasis cardiovascular disease myocardial infarction stroke epidemiology self-controlled case series http://www.atsjournals.org/doi/10.1513/AnnalsATS.201706-488OC doi:10.1513/AnnalsATS.201706-488OC doi:10.1513/AnnalsATS.201706-488OC
spellingShingle Bronchiectasis
cardiovascular disease
myocardial infarction
stroke
epidemiology
self-controlled case series
Navaratnam, Vidya
Root, Adrian A
Douglas, Ian
Smeeth, Liam
Hubbard, Richard B.
Quint, Jennifer K.
Cardiovascular outcomes following a respiratory tract infection among adults with non-CF bronchiectasis: a general population based study
title Cardiovascular outcomes following a respiratory tract infection among adults with non-CF bronchiectasis: a general population based study
title_full Cardiovascular outcomes following a respiratory tract infection among adults with non-CF bronchiectasis: a general population based study
title_fullStr Cardiovascular outcomes following a respiratory tract infection among adults with non-CF bronchiectasis: a general population based study
title_full_unstemmed Cardiovascular outcomes following a respiratory tract infection among adults with non-CF bronchiectasis: a general population based study
title_short Cardiovascular outcomes following a respiratory tract infection among adults with non-CF bronchiectasis: a general population based study
title_sort cardiovascular outcomes following a respiratory tract infection among adults with non-cf bronchiectasis: a general population based study
topic Bronchiectasis
cardiovascular disease
myocardial infarction
stroke
epidemiology
self-controlled case series
url https://eprints.nottingham.ac.uk/49007/
https://eprints.nottingham.ac.uk/49007/
https://eprints.nottingham.ac.uk/49007/