Serious Infection After Acute Myocardial Infarction

Truffa, Adriano A. M.; Granger, Christopher B.; White, Kyle; Newby, L. Kristin; Mehta, Rajendra H.; Hochman, Judith S.; Patel, Manesh R.; Pieper, Karen S.; Al‐Khalidi, Hussein R.; Armstrong, Paul W.; Lópes, Renato D.

doi:10.1016/j.jcin.2012.03.018

Cited by 48 publications

(30 citation statements)

References 37 publications

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“…Using the disjunctive cause criterion (VanderWeele and Shpitser 2011 ) for confounder identification, we included age (in years), sex, socioeconomic status (SES) (Donnelly et al 2018 ), history of stroke (Chamorro et al 2007 ), any kind of cancer (Rolston 2017 ), myocardial infarction (Truffa et al 2012 ), diabetes mellitus type 1 or 2 (Casqueiro et al 2012 ), smoking status (Bagaitkar et al 2008 ), BMI (kg/m 2 ; with BMI > 30 defined as obese according to WHO definition (Dobner and Kaser 2018 ; WHO 2019 )), and hypertension as potential confounders (Gu et al 2017 ). All potential confounders were assessed as self-reported variables at baseline only, using a standardized interview.…”

Section: Methodsmentioning

confidence: 99%

Seropositivity for pathogens associated with chronic infections is a risk factor for all-cause mortality in the elderly: findings from the Memory and Morbidity in Augsburg Elderly (MEMO) Study

et al. 2020

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Immunostimulation by chronic infection has been linked to an increased risk for different non-communicable diseases, which in turn are leading causes of death in high- and middle-income countries. Thus, we investigated if a positive serostatus for pathogens responsible for common chronic infections is individually or synergistically related to reduced overall survival in community dwelling elderly. We used data of 365 individuals from the German MEMO (Memory and Morbidity in Augsburg Elderly) cohort study with a median age of 73 years at baseline and a median follow-up of 14 years. We examined the effect of a positive serostatus at baseline for selected pathogens associated with chronic infections (Helicobacter pylori, Borrelia burgdorferi sensu lato, Toxoplasma gondii, cytomegalovirus, Epstein-Barr virus, herpes simplex virus 1/2, and human herpesvirus 6) on all-cause mortality with multivariable parametric survival models. We found a reduced survival time in individuals with a positive serostatus for Helicobacter pylori (accelerated failure time (AFT) − 15.92, 95% CI − 29.96; − 1.88), cytomegalovirus (AFT − 22.81, 95% CI − 36.41; − 9.22) and Borrelia burgdorferi sensu lato (AFT − 25.25, 95% CI − 43.40; − 7.10), after adjusting for potential confounders. The number of infectious agents an individual was seropositive for had a linear effect on all-cause mortality (AFT per additional infection − 12.42 95% CI − 18.55; − 6.30). Our results suggest an effect of seropositivity for Helicobacter pylori, cytomegalovirus, and Borrelia burgdorferi sensu lato on all-cause mortality in older community dwelling individuals. Further research with larger cohorts and additional biomarkers is required, to assess mediators and molecular pathways of this effect.

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Section: Methodsmentioning

confidence: 99%

Seropositivity for pathogens associated with chronic infections is a risk factor for all-cause mortality in the elderly: findings from the Memory and Morbidity in Augsburg Elderly (MEMO) Study

et al. 2020

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“…Data from 5745 patients with STEMI enrolled in the APEX-AMI trial demonstrated that the prevalence of serious infection was 2.4% and that infection was associated with higher 90-day mortality (29%). 9 Also, another study of 1486 patients with STEMI reported the prevalence of serious infection at 3.9% and the 30-day mortality was up to 53% in these patients. 8 The conclusions of these two studies paralleled our conclusion: infection is uncommon but associated with worse clinical outcomes.…”

Section: Discussionmentioning

confidence: 97%

Impact of infection in patients with non-ST elevation acute coronary syndrome undergoing percutaneous coronary intervention: insight from a multicentre observational cohort from China

Chen¹,

Liu²,

Duan

et al. 2020

BMJ Open

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ObjectiveWe aimed to describe the association between in-hospital infection and prognosis among patients with non-ST elevation acute coronary syndrome (NSTE-ACS) who received percutaneous coronary intervention (PCI).DesignThis observational cohort originated from a database of patients with NSTE-ACS who underwent PCI from 1 January 2010 to 31 December 2014.SettingFive centres in South China.ParticipantsThis multicentre observational cohort study consecutively included 8197 patients with NSTE-ACS who received PCI. Only patients with adequate information to diagnose or rule out infection were included. Patients were excluded if they were diagnosed with a malignant tumour, were pregnant or presented with cardiogenic shock at the index date. Patients were grouped by whether they had in-hospital infection or not.Primary and secondary outcome measuresThe primary outcome was all-cause death and major bleeding during hospitalisation. The secondary outcomes included all-cause death and major bleeding during follow-up and in-hospital myocardial infarction.ResultsOf the 5215 patients, 206 (3.95%) acquired infection. Patients with infection had a higher rate of in-hospital all-cause death and major bleeding (4.4% vs 0.2% and 16.5% vs 1.2%, respectively; p<0.001). After adjusting for confounders, infection remained independently associated with in-hospital and long-term all-cause death (OR, 13.19, 95% CI 4.59 to 37.87; HR, 2.03, 95% CI 1.52 to 2.71; p<0.001) and major bleeding (OR, 10.24, 95% CI 6.17 to 16.98; HR, 5.31, 95% CI 3.49 to 8.08; p<0.001). A subgroup analysis confirmed these results.ConclusionsThe incidence of infection is low during hospitalisation, but is associated with worse in-hospital and long-term outcomes.

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“…However, since no high-quality IMT study has been conducted in patients with AMI, we decided to calculate the sample size for our study using inspiratory muscle strength, and later extended this to better explore the effect of IMT on the secondary endpoints, especially pneumonia. Fourth, the model for calculating the risk of pneumonia was based on previous work in patients with ST-elevation myocardial infarction, without validation of its accuracy in our selected patient population ( 1 , 2 ). Because there are not risk model for pneumonia in patients with AMI currently.…”

Section: Discussionmentioning

confidence: 99%

“…After reviewing the results of previous studies and the clinical risk factors for pneumonia ( 1 , 2 , 7 , 10 ), the following parameters will be used for pneumonia risk calculation: (1) age > 55 years; (2) history of diabetes mellitus, (3) present smoker; (4) chronic kidney disease [estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73m 2 )]; and (5) forced expiratory volume in the first second of expiration (FEV 1 ) <80% predicted and FEV 1 /forced vital capacity (FVC) <70% predicted. Having two or more of these parameters is regarded as being high risk for pneumonia.…”

Section: Methodsmentioning

confidence: 99%

The Safety and Efficacy of Inspiratory Muscle Training for Patients With Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention: Study Protocol for a Randomized Controlled Trial

Liu

Dai

Liu

et al. 2021

Front. Cardiovasc. Med.

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Background: Uncommonly high rates of pneumonia in patients with acute myocardial infarction (AMI) undergoing primary percutaneous coronary intervention (PCI) have been observed during recent years. Inspiratory muscle training (IMT) could reduce pneumonia in patients undergoing coronary artery bypass grafting and other cardiac surgeries. The relationship between IMT and AMI is unknown. Here, we describe the feasibility and potential benefit of IMT in patients at high risk for pneumonia with AMI who have undergone primary PCI.Methods: Our study is a prospective, randomized, controlled, single-center clinical trial. A total of 60 participants will be randomized into an IMT group and control group with 30 participants in each group. Participants in the IMT group will undergo training for 15 min per session, twice a day, from 12 to 24 h after primary PCI, until 30 days post-randomization; usual care will be provided for the control group. The primary endpoint is the change in inspiratory muscle strength, the secondary endpoint included feasibility, pneumonia, major adverse cardiovascular events, length of stay, pulmonary function tests measure, and quality of life.Discussion: Our study is designed to evaluate the feasibility of IMT and its effectiveness in improving inspiratory muscle strength in participants with AMI who have undergone primary PCI.Clinical Trial Registration:www.ClinicalTrials.gov, identifier: NCT04491760.

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Serious Infection After Acute Myocardial Infarction

Cited by 48 publications

References 37 publications

Seropositivity for pathogens associated with chronic infections is a risk factor for all-cause mortality in the elderly: findings from the Memory and Morbidity in Augsburg Elderly (MEMO) Study

Seropositivity for pathogens associated with chronic infections is a risk factor for all-cause mortality in the elderly: findings from the Memory and Morbidity in Augsburg Elderly (MEMO) Study

Impact of infection in patients with non-ST elevation acute coronary syndrome undergoing percutaneous coronary intervention: insight from a multicentre observational cohort from China

The Safety and Efficacy of Inspiratory Muscle Training for Patients With Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention: Study Protocol for a Randomized Controlled Trial

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