Risk of stroke and myocardial infarction after influenza-like illness in New York State.
Risk of stroke and myocardial infarction after influenza-like illness in New York State.
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DOI：
10.1186/s12889-021-10916-4
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发表时间：
2021-05-05
影响因子：
4.5
通讯作者：
Boehme AK
中科院分区：
文献类型：
--
作者：
Kulick ER;Alvord T;Canning M;Elkind MSV;Chang BP;Boehme AK
流感可能与中风和心肌梗死（MI）风险增加有关。我们假设在纽约州，流感样疾病（ILI）后中风和心肌梗死的风险会更高。我们还评估了这种关系在一系列社会人口因素中是否存在差异。
对2012 - 2014年纽约全州规划与研究合作系统（SPARCS）进行了病例交叉分析，以评估流感样疾病后缺血性中风和心肌梗死的几率。在用于估计比值比和95%置信区间（OR，95%CI）的条件逻辑回归模型中，将每个患者的病例窗口期（事件发生前的时间段）与其对照窗口期（前两年的相同日期）进行比较。我们将病例窗口期设定为事件发生前15至365天，并与使用前两年相同日期构建的对照窗口期进行比较。根据居住邮政编码按性别、种族和城乡状况对分析进行分层。
共有33742名患者被确定患有缺血性中风，53094名患者患有心肌梗死。在事件发生前15天内的流感样疾病事件与缺血性中风几率增加39%相关（95%CI 1.09 - 1.77），当观察过去一年的流感样疾病事件时，几率增加近70%（95%CI 1.56，1.83）。相比之下，流感样疾病住院对心肌梗死的影响在事件发生前15天内最强（OR = 1.24，95%CI 1.06 - 1.44）。在中风前90天内居住在农村地区的个体以及事件发生前一年的男性中，流感样疾病后缺血性中风的风险更高。相比之下，流感样疾病与心肌梗死之间的关联仅因种族而异，白人因流感样疾病导致的心肌梗死风险明显更高。
这项研究强调了流感样疾病后急性心血管事件的风险期差异，表明流感样疾病后中风风险与心肌梗死风险背后的机制可能存在差异。流感样疾病后中风的高危人群包括男性和居住在农村地区的人，而白人在流感样疾病后患心肌梗死的风险较高。未来需要进行研究以确定降低这些风险的方法。
Influenza may be associated with increased stroke and myocardial infarction (MI) risk. We hypothesized that risk of stroke and MI after influenza-like illness (ILI) would be higher in patients in New York State. We additionally assessed whether this relationship differed across a series of sociodemographic factors. A case-crossover analysis of the 2012–2014 New York Statewide Planning and Research Cooperative System (SPARCS) was used to estimate odds of ischemic stroke and MI after ILI. Each patient’s case window (the time period preceding event) was compared to their control windows (same dates from the previous 2 years) in conditional logistic regression models used to estimate odds ratios and 95% confidence intervals (OR, 95% CI). We varied the case windows from 15 to 365 days preceding event as compared to control windows constructed using the same dates from the previous 2 years. Analyses were stratified by sex, race, and urban-rural status based on residential zip code. A total of 33,742 patients were identified as having ischemic stroke and 53,094 had MI. ILI events in the 15 days prior were associated with a 39% increase in odds of ischemic stroke (95% CI 1.09–1.77), increasing to an almost 70% increase in odds when looking at ILI events over the last year (95% CI 1.56, 1.83). In contrast, the effect of ILI hospitalization on MI was strongest in the 15 days prior (OR = 1.24, 95% CI 1.06–1.44). The risk of ischemic stroke after ILI was higher among individuals living in rural areas in the 90 days prior to stroke and among men in the year prior to event. In contrast, the association between ILI and MI varied only across race with whites having significantly higher ILI associated MI. This study highlights risk period differences for acute cardiovascular events after ILI, indicating possible differences in mechanism behind the risk of stroke after ILI compared to the risk of MI. High risk populations for stroke after ILI include men and people living in rural areas, while whites are at high risk for MI after ILI. Future studies are needed to identify ways to mitigate these risks.
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影响因子：
105.7
作者：
SYRJANEN, J;VALTONEN, VV;HUTTUNEN, JK
通讯作者：
HUTTUNEN, JK
影响因子：
2
作者：
Vogel, Todd R.
通讯作者：
Vogel, Todd R.
DOI：
10.1136/bmj.h5651
发表时间：
2015-11-04
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Burke JF;Sussman JB;Kent DM;Hayward RA
通讯作者：
Hayward RA
影响因子：
8.3
作者：
Kokotailo, RA;Hill, MD
通讯作者：
Hill, MD
影响因子：
37.8
作者：
Benjamin, Emelia J.;Virani, Salim S.;Muntner, Paul
通讯作者：
Muntner, Paul