Background Atherosclerosis is a chronic inflammatory condition and growing evidence links systemic inflammation with accelerated atherogenesis. Infectious disease is a common cause of inflammation and it’s impact on atherosclerotic disease is less studied. Using a big data approach we studied the risk of atherosclerotic disease and outcome following respiratory and urinary tract infections.
Methods We used a retrospective, longitudinal naturalistic follow-up design using the Algorithm for Comorbidities, Associations, Length of stay and Mortality (ACALM) study of 1,220,024 patients admitted to UK hospitals between 2000–2013. All patients aged 40 with urinary/chest infection on index admission (but no previous ischaemic heart disease (IHD) or ischaemic stroke) were followed-up for development of IHD or stroke and compared with an age/gender matched control group (n=34,02, 59% female, mean age 73±14). Logistic regression adjusted for cardiovascular risk factors and top causes of death was performed comparing rates of developing IHD, ischaemic stroke and mortality.
Results Patients with a prior infection had higher unadjusted incidences of IHD (9.9% vs 5.9%) and stroke (4.2% vs 1.5%). Figure 1 shows adjusted risk factors associated with development of IHD and stroke.%). Logistic regression demonstrated that prior infection was associated with 36% higher risk of developing IHD (OR 1.36 95% CI 1.28–1.44), and, 3 fold higher risk of mortality in those who developed IHD (OR 2.98 95% CI 2.52–3.51). Similarly, prior infection was associated with 2.5 fold increased risk of stroke (OR 2.50, 95% CI 2.26–2.78) and 80% higher risk of subsequent mortality (OR 1.80, 95% CI 1.27–2.52).
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