Data availability statement:
No additional data are available.
ABSTRACT:
Background:
Several studies imply that influenza and other respiratory illness could
lead to acute myocardial infarction (AMI), but data from low-income
countries are scarce. We investigated the prevalence of recent
respiratory illnesses and confirmed influenza in AMI patients, while
also exploring their relationship with infarction severity as defined by
ST-elevation MI (STEMI) or high troponin levels.
Methods: This cross-sectional study, held at a Dhaka tertiary
hospital from May 2017 to October 2018, involved AMI inpatients. The
study examined self-reported clinical respiratory illnesses (CRI) in the
week before AMI onset and confirmed influenza using baseline qRT-PCR.
Results: Of 744 patients, 11.3% reported a recent CRI, most
prominently during the 2017 influenza season (35.7%). qRT-PCR testing
found evidence of influenza in 1.5% of 546 patients, with all positives
among STEMI cases. Frequencies of CRI were higher in patients with STEMI
and in those with high troponin levels, although these associations were
not statistically significant after adjusting for other variables. The
risk of STEMI was significantly greater during influenza seasons in
unadjusted analysis (RR: 1.09, 95% CI: 1.02- 1.18), however, this
relationship was not significant in the adjusted analysis (aRR: 1.03,
95% CI: 0.91- 1.16).
Conclusions: In Bangladesh, many AMI patients had a recent
respiratory illness history, with some showing evidence of influenza.
However, these illnesses showed no significant relationship to AMI
severity. Further research is needed to understand these associations
better and to investigate the potential benefits of infection control
measures and influenza vaccinations in reducing AMI incidence.