In-Hospital Management and Outcomes of Patients With Acute Myocardial Infarction and Influenza

Cardoso, Rhanderson; Rivera, Manuel; Czarny, Matthew J.; Knijnik, Leonardo; Fernandes, Amanda; Blumenthal, Roger S.; Hasan, Rani K.; Schulman, Steven P.

doi:10.1016/j.amjcard.2019.12.032

Cited by 18 publications

(27 citation statements)

References 19 publications

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“…Dysregulated immune responses associated with multiple chronic conditions result from the chronically elevated levels of circulating inflammatory cytokines, often characterized as 'inflammaging' [10], and could very well be the mechanistic link to these complications of influenza. Specifically, the six leading causes of catastrophic disability including strokes [11,12], congestive heart failure [13,14], pneumonia and influenza [15][16][17][18][19][20][21][22][23][24][25], ischemic heart disease [8,11,26,27], cancer and hip fracture [28,29], have all been linked to influenza illness. Furthermore, 15% of older adults admitted with laboratory-confirmed influenza will experience catastrophic disability with a loss of independence in more than two basic self-care activities [30] and older adults are also vulnerable to diminished quality of life due to loss of independence following hospitalization with influenza [25].…”

Section: Burden Of Influenzamentioning

confidence: 99%

The immune response to influenza in older humans: beyond immune senescence

et al. 2020

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Despite widespread influenza vaccination programs, influenza remains a major cause of morbidity and mortality in older adults. Age-related changes in multiple aspects of the adaptive immune response to influenza have been well-documented including a decline in antibody responses to influenza vaccination and changes in the cellmediated response associated with immune senescence. This review will focus on T cell responses to influenza and influenza vaccination in older adults, and how increasing frailty or coexistence of multiple (≥2) chronic conditions contributes to the loss of vaccine effectiveness for the prevention of hospitalization. Further, dysregulation of the production of pro-and anti-inflammatory mediators contributes to a decline in the generation of an effective CD8 T cell response needed to clear influenza virus from the lungs. Current influenza vaccines provide only a weak stimulus to this arm of the adaptive immune response and rely on re-stimulation of CD8 T cell memory related to prior exposure to influenza virus. Efforts to improve vaccine effectiveness in older adults will be fruitless until CD8 responses take center stage.

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Section: Burden Of Influenzamentioning

confidence: 99%

The immune response to influenza in older humans: beyond immune senescence

et al. 2020

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“…Available data have shown increased in-hospital mortality due to pneumonia and influenza in patients with AMI. 8 , 10 , 11 However, no accurate data is reported on the role of concomitant pneumonia and influenza in patients with AMI-CS. Hence, using a large national database, we sought to assess the prevalence and impact of these respiratory infections on outcomes in AMI-CS.…”

Section: Introductionmentioning

confidence: 99%

“…The in-hospital mortality was lower among AMI-CS admissions with respiratory infections (31.6% vs 38.4%, adjusted OR 0.58 [95% CI 0.57–0.59], p < 0.001). Admissions with respiratory infections had longer lengths of hospital stay (12 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 vs 6 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 days, p < 0.001), higher hospitalization costs and less frequent discharges to home (27.1% vs 44.7%, p < 0.001).…”

mentioning

confidence: 99%

Impact of concomitant respiratory infections in the management and outcomes acute myocardial infarction-cardiogenic shock

Patlolla

Sundaragiri²,

Cheungpasitporn

et al. 2021

Indian Heart Journal

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Objective To evaluate the prevalence and impact of respiratory infections in cardiogenic shock complicating acute myocardial infarction (AMI-CS). Methods Using the National Inpatient Sample (2000–2017), this study identified adult (≥18 years) admitted with AMI-CS complicated by respiratory infections. Outcomes of interest included in-hospital mortality of AMI-CS admissions with and without respiratory infections, hospitalization costs, hospital length of stay, and discharge disposition. Temporal trends of prevalence, in-hospital mortality and cardiac procedures were evaluated. Results Among 557,974 AMI-CS admissions, concomitant respiratory infections were identified in 84,684 (15.2%). Temporal trends revealed a relatively stable trend in prevalence of respiratory infections over the 18-year period. Admissions with respiratory infections were on average older, less likely to be female, with greater comorbidity, had significantly higher rates of NSTEMI presentation, and acute non-cardiac organ failure compared to those without respiratory infections (all p < 0.001). These admissions received lower rates of coronary angiography (66.8% vs 69.4%, p < 0.001) and percutaneous coronary interventions (44.8% vs 49.5%, p < 0.001), with higher rates of mechanical circulatory support, pulmonary artery catheterization, and invasive mechanical ventilation compared to AMI-CS admissions without respiratory infections (all p < 0.001). The in-hospital mortality was lower among AMI-CS admissions with respiratory infections (31.6% vs 38.4%, adjusted OR 0.58 [95% CI 0.57–0.59], p < 0.001). Admissions with respiratory infections had longer lengths of hospital stay (12 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 vs 6 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 days, p < 0.001), higher hospitalization costs and less frequent discharges to home (27.1% vs 44.7%, p < 0.001). Conclusions Respiratory infections in AMI-CS admissions were associated with higher resource utilization but lower in-hospital mortality.

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“…The patients were between 62 and 85 years old and had more comorbidities than those without influenza infection. Acute myocardial infarction without ST elevation was observed in 90% of cases, while in those without influenza it was 74% (7).…”

Section: Introductionmentioning

confidence: 94%

Cardiovascular diseases associated with influenza infection: protocol for a systematic review and meta-analysis

Torres

Yamahuchi

Ramos

et al. 2021

Preprint

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Background: Cardiovascular diseases represent important diagnoses that can become fatal if an early and adequate management is not carried out. Since 1930, a possible relationship between these events and influenza virus infection has been proposed. Objectives: To determine the association between cardiovascular diseases and previous infection by influenza virus. Materials and methods: A systematic review was carried out according to PRISMA. The electronic search was carried out in the databases of EMBASE, PubMed, Global Index Medicus, Google Scholar and Cochrane Library. The included studies had laboratory-confirmed influenza in patients over 18 years of age; studies that considered pregnant patients or animals were excluded. The quality of the studies was verified using the standardized tool of the National Heart Lung and Blood Institute and the certainty of the results was assessed with GRADE. In addition, 2 meta-analysis of the association measures were performed using the Cochrane Software Review Manager 5.4.1. Results: 31 records were identified, of which 4 were included (n = 1101). These studies were conducted in Finland, China, and Australia. The estimated combined OR for the positive association between influenza A and acute myocardial infarction obtained was 2.52 (95% CI 1.59 - 4); and in the association with influenza B, an OR of 4.78 ( 95% CI 1.57-14.61). The OR obtained for the association with myocarditis was 5.23 (95% CI 1.00 - 27.32). Conclusions: Evidence of almost 5 times the risk of suffering acute myocardial infarction was found in those who had a previous episode of influenza B, and almost 3 with influenza A. Better quality longitudinal studies are required to confirm this finding.

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In-Hospital Management and Outcomes of Patients With Acute Myocardial Infarction and Influenza

Cited by 18 publications

References 19 publications

The immune response to influenza in older humans: beyond immune senescence

The immune response to influenza in older humans: beyond immune senescence

Impact of concomitant respiratory infections in the management and outcomes acute myocardial infarction-cardiogenic shock

Cardiovascular diseases associated with influenza infection: protocol for a systematic review and meta-analysis

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