Laboratory confirmed respiratory infections as vascular triggers

The Problem

Cardiovascular disease remains the UK’s leading cause of death. Respiratory viruses such as influenza and bacteria such as Streptococcus pneumoniae are common, potentially preventable causes of serious morbidity and mortality in vulnerable groups.

Influenza and pneumococcal vaccines are available, but under-utilised, especially among clinical risk groups, including people with cardiac disease. Limited data suggest that antivirals used to treat influenza may reduce the risk of adverse coronary events. Establishing the differential role of specific viruses and bacteria on cardiac and vascular events will allow greater mechanistic understanding, potentially leading to investment in developing new therapeutic options, as well as better targeting of existing interventions.

Our Research

Our earlier work using electronic health records from primary and secondary care found that acute respiratory infections have a transient triggering effect on myocardial infarction (MI), especially among older people. We showed a relationship between influenza circulation and MI hospitalisations and deaths using data from both England & Wales and Hong Kong. Now we are investigating the role of specific laboratory-confirmed respiratory infections ascertained through large national infection surveillance datasets from Public Health England in triggering a range of cardiac and vascular events. We are extending the work internationally using linked health records data from partners in Scotland and Denmark, to inform vaccine and antiviral policy and practice.