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Coronary and Cerebrovascular Events and Exacerbation of Existing Conditions After Laboratory‐Confirmed Influenza Infection Among US Veterans: A Self‐Controlled Case Series Study
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Coronary and Cerebrovascular Events and Exacerbation of Existing Conditions After Laboratory‐Confirmed Influenza Infection Among US Veterans: A Self‐Controlled Case Series Study
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Journal Article
Coronary and Cerebrovascular Events and Exacerbation of Existing Conditions After Laboratory‐Confirmed Influenza Infection Among US Veterans: A Self‐Controlled Case Series Study
2024
Overview
ABSTRACT
Background
Influenza may contribute to coronary/cerebrovascular events and exacerbate underlying conditions.
Methods
We used self‐controlled case series (SCCS) design to analyze data from US Veterans ≥18 years with coronary/cerebrovascular or exacerbation event +/−1 year of lab‐confirmed influenza (LCI) during 2010–2018. We estimated the incidence ratio (IR) (95% CI) of the event for risk interval (Days 1–7 post‐LCI) versus control interval (all other times +/−1 year of LCI) with fixed‐effects conditional Poisson regression. We included biomarker data for mediation analysis.
Results
We identified 3439 episodes with coronary/cerebrovascular‐related hospitalizations. IRs (95% CI) for LCI risk versus control interval were STEMI 0.6 (0.1, 4.4), NSTEMI 7.3 (5.8, 9.2), ischemic stroke 4.0 (3.0, 5.4), hemorrhagic stroke 6.2 (3.4, 11.5), and coronary spasm 1.3 (0.5, 3.0). IR significantly increased for NSTEMI and ischemic stroke among those ≥ 65 years. IR for NSTEMI and ischemic stroke dropped 26% and 10%, respectively, when white blood cell (WBC) and platelet count were considered. LCI was significantly associated with exacerbation of preexisting asthma, chronic obstructive pulmonary disease, and congestive heart failure.
Conclusions
We found significant association between LCI and hospitalization for NSTEMI, ischemic stroke, and hemorrhagic stroke, the latter possibly due to unaccounted time‐varying confounding in SCCS design.
Publisher
John Wiley & Sons, Inc,John Wiley and Sons Inc
Subject
/ Aged
/ AMI
/ Asthma
/ Cerebrovascular Disorders - epidemiology
/ Chronic obstructive pulmonary disease
/ coronary
/ Female
/ Hospitalization - statistics & numerical data
/ Humans
/ Influenza, Human - complications
/ Influenza, Human - epidemiology
/ Ischemia
/ Male
/ Medicare
/ Original
/ Stroke
/ United States - epidemiology
/ Veterans
