Cardiovascular Outcomes after a Respiratory Tract Infection among Adults with Non-Cystic Fibrosis Bronchiectasis: A General Population-based Study

TitleCardiovascular Outcomes after a Respiratory Tract Infection among Adults with Non-Cystic Fibrosis Bronchiectasis: A General Population-based Study
Publication TypeJournal Article
Year of Publication2018
AuthorsNavaratnam V., Root A.A, Douglas I., Smeeth L., Hubbard R.B, Quint J.K
JournalAnnals of the American Thoracic Society
Volume15
Pagination315-321
Date PublishedMar
ISBN Number2325-6621
Accession Number29266966
Keywordsbronchiectasis, cardiovascular disease, myocardial infarction, self-controlled case series, Stroke
Abstract

RATIONALE: Studies suggest that adults with bronchiectasis are at increased risk of cardiovascular comorbidities. OBJECTIVES: We aimed to quantify the relative risk of incident cardiovascular events after a respiratory tract infection among adults 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 or stroke) after a respiratory tract infection compared with the individual's baseline risk. RESULTS: Our cohort consisted of 895 adult men and women with non-cystic fibrosis bronchiectasis with a first myocardial infarction 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, 1.56; 95% confidence interval, 1.20-2.02). The rate of a first cardiovascular event was highest in the first 3 days after a respiratory tract infection (incidence rate ratio, 2.73; 95% confidence interval, 1.41-5.27). CONCLUSIONS: These data suggest that respiratory tract infections are strongly associated with a transient increased risk of first-time myocardial infarction or stroke among 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.

Short TitleAnnals ATS
Alternate JournalAnnals of the American Thoracic Society