Preventing Cardiovascular Complications of Acute Infection

Walkey, Allan J.

doi:10.1161/circulationaha.114.008712

Cited by 14 publications

(6 citation statements)

References 20 publications

(23 reference statements)

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“…Optimal preventive treatment strategies are lacking because the mechanism of cardiovascular complications after infection is unclear. 9 Possible strategies may include optimal treatment of bacteremia, anticoagulation during and after bacteremia, or vaccination of individuals at risk. We found that risk factors that may help to designate high-risk individuals of ATE after bacteremia include old age, prior ATE, atrial flutter/fibrillation, hypertension and endocarditis.…”

Section: Discussionmentioning

confidence: 99%

Increased risk of arterial thromboembolic events after Staphylococcus aureus bacteremia: A matched cohort study

Mejer

Gotland

Uhre

et al. 2015

Journal of Infection

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Section: Discussionmentioning

confidence: 99%

Increased risk of arterial thromboembolic events after Staphylococcus aureus bacteremia: A matched cohort study

Mejer

Gotland

Uhre

et al. 2015

Journal of Infection

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“…Patients with new-onset AF during acute illness also have elevated long-term risks of stroke, [27][28][29] heart failure, and death. 28,29 Among patients with new-onset AF during sepsis who had an ischemic stroke following a hospitalization for sepsis, nearly onehalf were not given another AF diagnosis before the stroke, a fi nding that highlights the possibility that AF occurring during an acute illness may represent a previous missed opportunity 30 to recognize AF 31 and potentially reduce long-term cardiovascular events. Given the potential consequences for long-term events, improved documentation of new AF events during a hospitalization and communication between inpatient and outpatient providers are warranted.…”

mentioning

confidence: 99%

Optimizing Atrial Fibrillation Management

Walkey

Hogarth

Lip

2015

Chest

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“…The novel suggestion herein for low-dose aspirin usage to mitigate high short-term cardiac risk in males while fasting for Ramadan is similar to that proposed during severe infections and in susceptible males during marathons [13,14]. Studies on validated biomarkers for stratifying transient cardiovascular risk in pilgrims while observing the Hajj in Mecca during Ramadan would provide hard data to support such usage as shown in asymptomatic male marathon runners (Figure 1).…”

Section: Discussionmentioning

confidence: 69%

Reprising Ramadan-Related Angina Pectoris: A Potential Strategy for Risk Reduction

2016

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Patient: Male, 69Final Diagnosis: Coronary artery diseaseSymptoms: Angina pectorisMedication: AspirinClinical Procedure: Coronary artery bypass surgerySpecialty: CardiologyObjective:Unusual clinical courseBackground:A preponderance of evidence supports short-term aspirin usage to reduce transiently increased cardiovascular risk in clinical conditions that promote acute myocardial ischemia.Case Report:We report on the case of a 69-year-old male of Muslim Indian heritage with multiple cardiovascular risk factors who experienced the onset of angina pectoris while fasting for Ramadan for more than 16 hours daily for 30 days in July 2015. While symptom free for 2 months on medical management after ending his fast, he underwent quadruple coronary artery bypass surgery for severe 4-vessel disease following an acute anterior myocardial infarction. A percutaneous coronary intervention with stent placement was subsequently required for persistent myocardial ischemia on stress-MIBI testing due to occlusion of the graft to left anterior descending artery. Presently asymptomatic, he decided to forgo fasting for Ramadan in June 2016.Conclusions:Based on this case, measures for primary cardiovascular prevention among the 1.2 billion susceptible males at similar high short-term cardiac risk while fasting for Ramadan are proposed. The value of aspirin for attenuating high short-term cardiovascular risk in clinical conditions conferring transient inflammatory stress is considered.Low-dose aspirin usage at evening meals while fasting for Ramadan is prudent for primary cardiovascular protection of males who may have non-obstructive coronary atherosclerosis to mitigate the risk for rupture of potentially vulnerable plaques. Based in part on conclusive evidence for protection of middle-aged males from first myocardial infarction in a randomized prospective primary prevention trial, this measure is concordant with recommendations from sub-specialty societies for primary cardiovascular prevention for persons at above-average risk demonstrated by validated biomarkers and from the United States Preventive Services Task Force.

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Preventing Cardiovascular Complications of Acute Infection

Cited by 14 publications

References 20 publications

Increased risk of arterial thromboembolic events after Staphylococcus aureus bacteremia: A matched cohort study

Increased risk of arterial thromboembolic events after Staphylococcus aureus bacteremia: A matched cohort study

Optimizing Atrial Fibrillation Management

Reprising Ramadan-Related Angina Pectoris: A Potential Strategy for Risk Reduction

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