Causal relationship between influenza infection and risk of acute myocardial infarction: pathophysiological hypothesis and clinical implications

Muscente, Francesca; Caterina, Raffaele De

doi:10.1093/eurheartj/suaa064

Cited by 27 publications

(21 citation statements)

References 19 publications

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“…Authors have disclosed no conflicts of interest. 3 Centre for Fertility and Health (CeFH), Norwegian Institute of Public Health, Oslo, Norway. 4 Department of Medical Quality Registries, St. Olav's University Hospital, Trondheim, Norway.…”

Section: Supplementary Informationmentioning

confidence: 99%

“…Although, a vaccination might trigger coagulation abnormalities [3,4], studies showed that the benefits via preventing influenza clearly outweighs any adverse effects among individuals at high cardiovascular risk [5][6][7][8][9][10][11]. However, whether the benefits of the vaccine on cardiovascular events extend across the spectrum of cardiovascular risk are largely unknown.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Influenza vaccination and risk for cardiovascular events: a nationwide self-controlled case series study

Sen

Bakken

Govatsmark

et al. 2021

BMC Cardiovasc Disord

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Background US and European guidelines diverge on whether to vaccinate adults who are not at high risk for cardiovascular events against influenza. Here, we investigated the associations between influenza vaccination and risk for acute myocardial infarction, stroke and pulmonary embolism during the 2009 pandemic in Norway, when vaccination was recommended to all adults. Methods Using national registers, we studied all vaccinated Norwegian individuals who suffered AMI, stroke, or pulmonary embolism from May 1, 2009 through September 30, 2010. We defined higher-risk individuals as those using anti-diabetic, anti-obesity, anti-thrombotic, pulmonary or cardiovascular medications (i.e. individuals to whom vaccination was routinely recommended); all other individuals were regarded as having lower-risk. We estimated incidence rate ratios with 95% CI using conditional Poisson regression in the pre-defined risk periods up to 180 days following vaccination compared to an unexposed time-period, with adjustment for season or daily temperature. Results Overall, we observed lower risk for cardiovascular events following influenza vaccination. When stratified by baseline risk, we observed lower risk across all three outcomes in association with vaccination among higher-risk individuals. In this subgroup, relative risks were 0.72 (0.59–0.88) for AMI, 0.77 (0.59–0.99) for stroke, and 0.73 (0.45–1.19) for pulmonary embolism in the period 1–14 days following vaccination when compared to the background period. These associations remained essentially the same up to 180 days after vaccination. In contrast, the corresponding relative risks among subjects not using medications were 4.19 (2.69–6.52), 1.73 (0.91–3.31) and 2.35 (0.78–7.06). Conclusion In this nationwide study, influenza vaccination was associated with overall cardiovascular benefit. This benefit was concentrated among those at higher cardiovascular risk as defined by medication use. In contrast, our results demonstrate no comparable inverse association with thrombosis-related cardiovascular events following vaccination among those free of cardiovascular medications at baseline. These results may inform the risk–benefit balance for universal influenza vaccination.

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Section: Supplementary Informationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Influenza vaccination and risk for cardiovascular events: a nationwide self-controlled case series study

Sen

Bakken

Govatsmark

et al. 2021

BMC Cardiovasc Disord

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“…14 15 Third, a substantially decreased incidence of viral respiratory infections, including influenza, 16 might have decreased the incidence of AMI in these countries. 17 18…”

Section: Discussionmentioning

confidence: 99%

Decreased door-to-balloon time in patients with ST-segment elevation myocardial infarction during the early COVID-19 pandemic in South Korea – an observational study

Ryu

Kim

Jung

et al. 2021

Preprint

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Background: The coronavirus disease 2019 (COVID-19) resulted in a marked decrease in the number of patient visits for acute myocardial infarction (AMI) and delayed patient response and intervention in several countries. This study evaluated the effect of the COVID-19 pandemic on the number of patients, patient response time (pain-to-door), and intervention time (door-to-balloon) for patients with ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI). Methods: Patients with STEMI or NSTEMI visiting a hospital in South Korea who underwent primary coronary intervention during the COVID-19 pandemic (January 29, 2020, to December 31, 2020) were compared with those in the equivalent period in 2018 to 2019. Patient response and intervention times were compared for the COVID-19 pandemic window (2020) and the equivalent period in 2018 to 2019. Results: We observed no decrease in the number of patients with STEMI (P=0.50) and NSTEMI (P=0.94) during the COVID-19 pandemic compared to that in the previous years. Patient response times (STEMI: P=0.34; NSTEMI: P=0.89) during the overall COVID-19 pandemic period did not differ significantly. However, we identified a significant decrease in time to intervention among patients with STEMI (14%; p<0.01) during the early COVID-19 pandemic. Conclusions: We found that the number of patient with STEMI and NSTEMI was consistent during the COVID-19 pandemic and that no time delays in patient response and intervention occurred. However, the door-to-balloon time among patients with STEMI significantly reduced during the early COVID-19 pandemic, which could be attributed to reduced emergency care utilization during the early pandemic.

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“…Excessive sympathetic stimulation and elevated catecholamine levels can trigger a hyperdynamic cardiovascular response, which can alter systemic and coronary vascular tone, promote vasoconstriction, and induce occlusion by preexisting atherosclerotic plaques. 79 The changes in vascular tone, the hypercoagulable state, increased platelet aggregation, and accentuated frictional or shear stress can increase the biomechanical stress present on preexisting atherosclerotic coronary artery plaques and trigger a rupture. 80 A combination of these mechanisms may explain how SARS-CoV-2 infection can unmask symptoms of coronary ischemia or aggravate preexisting predisposing factors, leading to signs of an AMI.…”

Section: Myocardial Injury and Myocarditismentioning

confidence: 99%

Comprehensive Review of Cardiovascular Involvement in COVID-19

Cajanding

2021

AACN Advanced Critical Care

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COVID-19 has emerged as one of the most devastating and clinically significant infectious diseases of the last decade. It has reached global pandemic status at an unprecedented pace and has placed significant demands on health care systems worldwide. Although COVID-19 primarily affects the lungs, epidemiologic reports have shown that the disease affects other vital organs of the body, including the heart, vasculature, kidneys, brain, and the hematopoietic system. Of importance is the emerging awareness of the effects of COVID-19 on the cardiovascular system. The current state of knowledge regarding cardiac involvement in COVID-19 is presented in this article, with particular focus on the cardiovascular manifestations and complications of COVID-19 infection. The mechanistic insights of disease causation and the relevant pathophysiology involved in COVID-19 as they affect the heart are explored and described. Relevant practice essentials and clinical management implications for patients with COVID-19 with a cardiac pathology are presented in light of recent evidence.

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Causal relationship between influenza infection and risk of acute myocardial infarction: pathophysiological hypothesis and clinical implications

Cited by 27 publications

References 19 publications

Influenza vaccination and risk for cardiovascular events: a nationwide self-controlled case series study

Influenza vaccination and risk for cardiovascular events: a nationwide self-controlled case series study

Decreased door-to-balloon time in patients with ST-segment elevation myocardial infarction during the early COVID-19 pandemic in South Korea – an observational study

Comprehensive Review of Cardiovascular Involvement in COVID-19

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