Cardiovascular outcomes after a respiratory tract infection among adults with non-cystic fibrosis bronchiectasis: A general population-based study

Vidya Navaratnam, Adrian A. Root, Ian Douglas, Liam Smeeth, Richard B. Hubbard, Jennifer K. Quint

Research output: Journal PublicationArticlepeer-review

18 Citations (Scopus)

Abstract

Rationale: Studies suggest that adults with bronchiectasis are at increased risk of cardiovascular comorbidities. Objectives: We aimed to quantify the relative risk of incident cardiovascular events after a respiratory tract infection among adults with bronchiectasis. Methods: Using UK electronic primary care records, we conducted a within-person comparison using the self-controlled case series method. We calculated the relative risk of first-time cardiovascular events (either first myocardial infarction or stroke) after a respiratory tract infection compared with the individual's baseline risk. Results: Our cohort consisted of 895 adult men and women with non-cystic fibrosis bronchiectasis with a first myocardial infarction or stroke and at least one respiratory tract infection. There was an increased rate of first-time cardiovascular events in the 91-day period after a respiratory tract infection (incidence rate ratio, 1.56; 95% confidence interval, 1.20-2.02). The rate of a first cardiovascular event was highest in the first 3 days after a respiratory tract infection (incidence rate ratio, 2.73; 95% confidence interval, 1.41-5.27). Conclusions: These data suggest that respiratory tract infections are strongly associated with a transient increased risk of first-time myocardial infarction or stroke among people with bronchiectasis. As respiratory tract infections are six times more common in people with bronchiectasis than the general population, the increased risk has a disproportionately greater impact in these individuals. These findings may have implications for including cardiovascular risk modifications in airway infection treatment pathways in this population.

Original languageEnglish
Pages (from-to)315-321
Number of pages7
JournalAnnals of the American Thoracic Society
Volume15
Issue number3
DOIs
Publication statusPublished - Mar 2018
Externally publishedYes

Keywords

  • Bronchiectasis
  • Cardiovascular disease
  • Myocardial infarction
  • Self-controlled case series
  • Stroke

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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