Urinary Tract Infection Research Today is a free monthly online journal that collates and summarizes the latest research about Urinary Tract Infection, including details on uti, causes, prevention, diet, treatment.

Risk of myocardial infarction and stroke after acute infection or vaccination.

Smeeth L, Thomas SL, Hall AJ, Hubbard R, Farrington P, Vallance P

Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom. liam.smeeth@lshtm.ac.uk

BACKGROUND: There is evidence that chronic inflammation may promote atherosclerotic disease. We tested the hypothesis that acute infection and vaccination increase the short-term risk of vascular events. METHODS: We undertook within-person comparisons, using the case-series method, to study the risks of myocardial infarction and stroke after common vaccinations and naturally occurring infections. The study was based on the United Kingdom General Practice Research Database, which contains computerized medical records of more than 5 million patients. RESULTS: A total of 20,486 persons with a first myocardial infarction and 19,063 persons with a first stroke who received influenza vaccine were included in the analysis. There was no increase in the risk of myocardial infarction or stroke in the period after influenza, tetanus, or pneumococcal vaccination. However, the risks of both events were substantially higher after a diagnosis of systemic respiratory tract infection and were highest during the first three days (incidence ratio for myocardial infarction, 4.95; 95 percent confidence interval, 4.43 to 5.53; incidence ratio for stroke, 3.19; 95 percent confidence interval, 2.81 to 3.62). The risks then gradually fell during the following weeks. The risks were raised significantly but to a lesser degree after a diagnosis of urinary tract infection. The findings for recurrent myocardial infarctions and stroke were similar to those for first events. CONCLUSIONS: Our findings provide support for the concept that acute infections are associated with a transient increase in the risk of vascular events. By contrast, influenza, tetanus, and pneumococcal vaccinations do not produce a detectable increase in the risk of vascular events.

Published 16 December 2004 in N Engl J Med, 351(25): 2611-8.
Full-text of this article is available online (may require subscription).

© 2004-2008 Urinary Tract Infection Research Today. All Rights Reserved.