Key result
Concurrent acute infection was associated with higher unadjusted in-hospital mortality (11% vs 6%, p<0.01), but this was no longer significant after adjusting for confounders (OR 0.72).
Why the study?
Acute infection is suspected of involvement in the onset of acute MI, but its incidence, pathogenesis, and prognosis needed assessment.
Does a concurrent acute infection at admission worsen in-hospital mortality in patients hospitalized for acute myocardial infarction?
Cohort (n=4,573)
Does a concurrent acute infection at admission worsen in-hospital mortality in patients hospitalized for acute myocardial infarction?
Odds Ratio: 0.72 (95% CI 0.43–1.2)
Absolute Event Rate: 11% vs 6%
p-value: p=<0.01
Post-infectious MI is common (10% of acute MIs) and is associated with higher unadjusted in-hospital mortality, though this risk is attenuated after adjusting for confounders.
Screen for concurrent infection in acute MI admissions; leaves open whether infection independently worsens adjusted mortality.
Acute infection is suspected of involvement in the onset of acute myocardial infarction (MI). We aimed to assess the incidence, pathogenesis and prognosis of post-infectious MI. All consecutive patients hospitalized for an acute MI in coronary care units were prospectively included. Post-infectious MI was defined by a concurrent diagnosis of acute infection at admission. Type 1 MI (acute plaque disruption) or Type 2 MI (imbalance in oxygen supply/demand) were adjudicated according to the universal definition of MI. From the 4573 patients admitted for acute MI, 466 (10%) had a concurrent acute infection (median age 78 (66–85) y, 60% male), of whom 313 (67%) had a respiratory tract infection. Type 2 MI was identified in 72% of post-infectious MI. Compared with other MI, post-infectious MI had a worse in-hospital outcome (11 vs. 6% mortality, p < 0.01), mostly from cardiovascular causes. After adjusting for confounders, acute infections were no more associated with mortality (odds ratio 0.72; 95% confidence interval 0.43–1.20). In the group of post-infectious MI, Type 1 MI and respiratory tract infection were associated with a worse prognosis (respective odds ratio 2.44; 95% confidence interval: 1.12–5.29, and 2.89; 1.19–6.99). In this large MI survey, post-infectious MI was common, accounting for 10% of all MI, and doubled in-hospital mortality. Respiratory tract infection and Type 1 post-infectious MI were associated with a worse prognosis.
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Putot et al. (2019) conducted a cohort in Acute myocardial infarction (n=4,573). Concurrent acute infection vs. No concurrent acute infection (other MI) was evaluated on In-hospital mortality (OR 0.72, 95% CI 0.43-1.20, p=<0.01). Concurrent acute infection was associated with higher unadjusted in-hospital mortality (11% vs 6%, p<0.01), but this was no longer significant after adjusting for confounders (OR 0.72).
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