Association of Influenza-like Illness Activity With Hospitalizations for Heart Failure The Atherosclerosis Risk in Communities Study
Association of Influenza-like Illness Activity With Hospitalizations for Heart Failure The Atherosclerosis Risk in Communities Study
复制标题
DOI：
10.1001/jamacardio.2019.0549
复制
发表时间：
2019-04-01
期刊：
影响因子：
24
通讯作者：
Vardeny, Orly
中科院分区：
文献类型：
--
作者：
Kytomaa, Sonja;Hegde, Sheila;Vardeny, Orly
流感与心血管事件风险增加有关，但据我们所知，很少有研究探讨流感活动与住院之间的时间关系，特别是由心力衰竭（HF）引起的住院。目的探讨流感活动性与HF和心肌梗死（MI）住院之间的时间相关性。我们假设流感活动性的增加与社区成人心衰和心肌梗死住院率的增加有关。设计、环境和参与者作为社区动脉粥样硬化风险（ARIC）研究社区监测部分的一部分，这是一项基于人群的研究，从美国4个社区抽样住院，从2010年10月至2014年9月住院的年度横断面分层随机样本中收集了45588名年龄在35至84岁之间居住在ARIC社区的成年人的数据。每月流感活动性，定义为各州因流感样疾病就诊哨点临床医生的百分比，由疾病控制和预防中心监测网络报告。主要结果和测量：通过社区监测收集并作为ARIC研究的一部分判定的心肌梗死住院（n = 3541）和心衰住院（n = 4321）的每月频率。结果2010年10月至2014年9月，因心衰和心肌梗死住院的患者中，女性分别为2042例（47.3%）和1599例（45.1%），白人分别为2391例（53.3%）和2013例（57.4%）。在调整了地区、季节、种族/民族、性别、年龄和前一个月的心肌梗死/心衰住院人数后，流感活度每月绝对增加5%与同一月内每个社区总人口的心力衰竭住院率增加24%相关（发病率比，1.24;95% CI, 1.11-1.38; P < 0.001），而总体流感活度与心肌梗死住院率无显著相关性(发病率比，1.02；95% ci, 0.90-1.17；P = .72)。住院前几个月的流感活动与两种结果均无相关性。我们的模型显示，在流感高活动性的一个月里，大约19%的HF住院病例（95% CI, 10%-28%）可归因于流感。结论和相关性：在4个流感季节中，流感活动性与HF住院率的增加存在暂时性关联。这些数据表明，流感可能增加普通人群中心衰住院的风险。
IMPORTANCE Influenza is associated with an increased risk of cardiovascular events, but to our knowledge, few studies have explored the temporal association between influenza activity and hospitalizations, especially those caused by heart failure (HF).OBJECTIVE To explore the temporal association between influenza activity and hospitalizations due to HF and myocardial infarction (MI). We hypothesized that increased influenza activity would be associated with an increase in hospitalizations for HF and MI among adults in the community.DESIGN, SETTING, AND PARTICIPANTS As part of the community surveillance component of the Atherosclerosis Risk in Communities (ARIC) study, a population-based study with hospitalizations sampled from 4 US communities, data were collected from 451 588 adults aged 35 to 84 years residing in the ARIC communities from annual cross-sectional stratified random samples of hospitalizations during October 2010 to September 2014.EXPOSURES Monthly influenza activity, defined as the percentage of patient visits to sentinel clinicians for influenza-like illness by state, as reported by the Centers for Disease Control and Prevention Surveillance Network.MAIN OUTCOMES AND MEASURES The monthly frequency of MI hospitalizations (n = 3541) and HF hospitalizations (n = 4321), collected through community surveillance and adjudicated as part of the ARIC Study.RESULTS Between October 2010 and September 2014, 2042 (47.3%) and 1599 (45.1%) of the sampled patients who were hospitalized for HF and MI, respectively, were women and 2391 (53.3%) and 2013 (57.4%) were white, respectively. A 5% monthly absolute increase in influenza activity was associated with a 24% increase in HF hospitalization rates, standardized to the total population in each community, within the same month after adjusting for region, season, race/ethnicity, sex, age, and number of MI/HF hospitalizations from the month before (incidence rate ratio, 1.24; 95% CI, 1.11-1.38; P < .001), while overall influenza activity was not significantly associated with MI hospitalizations (incidence rate ratio, 1.02; 95% CI, 0.90-1.17; P = .72). Influenza activity in the months before hospitalization was not associated with either outcome. Our model suggests that in a month with high influenza activity, approximately 19% of HF hospitalizations (95% CI, 10%-28%) could be attributable to influenza.CONCLUSIONS AND RELEVANCE Influenza activity was temporally associated with an increase in HF hospitalizations across 4 influenza seasons. These data suggest that influenza may contribute to the risk of HF hospitalization in the general population.