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.

Abstract

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.

Citation

Navaratnam, V., Root, A. A., Douglas, I., Smeeth, L., Hubbard, R. B., & Quint, J. 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), https://doi.org/10.1513/AnnalsATS.201706-488OC

• Journal Article Type: Article
• Acceptance Date: Dec 20, 2017
• Online Publication Date: Dec 21, 2017
• Publication Date: Mar 1, 2018
• Deposit Date: Jan 10, 2018
• Publicly Available Date: Mar 14, 2018
• Journal: Annals of the American Thoracic Society
• Print ISSN: 2329-6933
• Electronic ISSN: 2325-6621
• Publisher: American Thoracic Society
• Peer Reviewed: Peer Reviewed
• Volume: 15
• Issue: 3
• DOI: https://doi.org/10.1513/AnnalsATS.201706-488OC
• Keywords: Bronchiectasis, cardiovascular disease, myocardial infarction, stroke, epidemiology, self-controlled case series
• Public URL: https://nottingham-repository.worktribe.com/output/918417
• Publisher URL: http://www.atsjournals.org/doi/10.1513/AnnalsATS.201706-488OC
• Contract Date: Jan 10, 2018