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Inpatient and Outpatient Infection as a Trigger of Cardiovascular Disease: The ARIC Study.

TitleInpatient and Outpatient Infection as a Trigger of Cardiovascular Disease: The ARIC Study.
Publication TypeJournal Article
Year of Publication2018
AuthorsCowan LT, Lutsey PL, Pankow JS, Matsushita K, Ishigami J
Secondary AuthorsLakshminarayan K
JournalJ Am Heart Assoc
Volume7
Issue22
Paginatione009683
Date Published2018 11 20
ISSN2047-9980
KeywordsAcute Disease, Aged, Cardiovascular Diseases, Case-Control Studies, Female, Humans, Infections, Inpatients, Logistic Models, Male, Odds Ratio, Outpatients, Risk Factors, Stroke, Time Factors
Abstract

Background Acute infections are known cardiovascular disease ( CVD ) triggers, but little is known regarding how CVD risk varies following inpatient versus outpatient infections. We hypothesized that in- and outpatient infections are associated with CVD risk and that the association is stronger for inpatient infections. Methods and Results Coronary heart disease (CHD) and ischemic stroke cases were identified and adjudicated in the ARIC (Atherosclerosis Risk in Communities Study). Hospital discharge diagnosis codes and Medicare claims data were used to identify infections diagnosed in in- and outpatient settings. A case-crossover design and conditional logistic regression were used to compare in- and outpatient infections among CHD and ischemic stroke cases (14, 30, 42, and 90 days before the event) with corresponding control periods 1 and 2 years previously. A total of 1312 incident CHD cases and 727 incident stroke cases were analyzed. Inpatient infections (14-day odds ratio [ OR ]=12.83 [5.74, 28.68], 30-day OR =8.39 [4.92, 14.31], 42-day OR =6.24 [4.02, 9.67], and 90-day OR =4.48 [3.18, 6.33]) and outpatient infections (14-day OR =3.29 [2.50, 4.32], 30-day OR =2.69 [2.14, 3.37], 42-day OR =2.45 [1.97, 3.05], and 90-day OR =1.99 [1.64, 2.42]) were more common in all CHD case periods compared with control periods and inpatient infection was a stronger CHD trigger for all time periods ( P

DOI10.1161/JAHA.118.009683
Alternate JournalJ Am Heart Assoc
PubMed ID30571501
PubMed Central IDPMC6404437
Grant ListT32 HL007779 / HL / NHLBI NIH HHS / United States