Risk and clinical outcomes of acute myocardial infarction and acute ischemic stroke following gram-negative bloodstream infection
Objectives: This retrospective cohort study examines incidence, risk factors, and clinical outcomes of acute myocardial infarction (AMI) and acute ischemic stroke (AIS) within one year of gram-negative bloodstream infection (GN-BSI) based on predefined clinical criteria. Methods: Hospitalized adults...
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2021-03-01
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doaj-4ddc9482330e4ccdb2f2e47ae01d90ab2021-03-25T04:31:31ZengElsevierInternational Journal of Cardiology. Hypertension2590-08622021-03-018100079Risk and clinical outcomes of acute myocardial infarction and acute ischemic stroke following gram-negative bloodstream infectionVinh-An D. Vo0Mazen K. Khalil1Majdi N. Al-Hasan2University of South Carolina School of Medicine, Columbia, SC, USAUniversity of South Carolina School of Medicine, Columbia, SC, USA; Department of Internal Medicine, Division of Cardiology, Prisma Health Midlands, Columbia, SC, USAUniversity of South Carolina School of Medicine, Columbia, SC, USA; Department of Internal Medicine, Division of Infectious Diseases, Prisma Health Midlands, Columbia, SC, USA; Corresponding author. Department of Internal Medicine, University of South Carolina School of Medicine, 2 Medical Park, Suite 502, Columbia, SC 29203, USA.Objectives: This retrospective cohort study examines incidence, risk factors, and clinical outcomes of acute myocardial infarction (AMI) and acute ischemic stroke (AIS) within one year of gram-negative bloodstream infection (GN-BSI) based on predefined clinical criteria. Methods: Hospitalized adults with GN-BSI at Prisma Health-Midlands hospitals in South Carolina, USA from 2010 through 2015 were identified. Kaplan-Meier analysis was used to determine incidence of AMI and AIS within one year after GN-BSI. Multivariate Cox proportional hazards regression models were used to examine risk factors for AMI or AIS and impact on 1-year mortality. Results: Among 1292 patients with GN-BSI, 263 and 17 developed AMI and AIS within 1-year with incidences of 23.4% and 1.9%, respectively. Majority of AMI were type 2 (164; 62%); 99 patients had type 1 AMI with incidence of 8.9%. Age >65 years (hazard ratio [HR] 1.52, 95% CI: 1.17–1.99), prior coronary artery disease or stroke (HR 1.74, 95% CI: 1.34–2.25), hypertension (HR 1.55, 95% CI: 1.13–2.15), end-stage renal disease (HR 1.52, 95% CI: 1.09–2.08), and quick Pitt bacteremia score (HR 1.55 per point, 95% CI: 1.40–1.72) were predictors of AMI/AIS. Development of type 1 AMI or AIS after GN-BSI was independently associated with increased 1-year mortality (HR 1.47, 95% CI: 1.03–2.07). Conclusions: AMI and AIS occur frequently within one year of GN-BSI and have negative impact on 1-year survival. Future randomized clinical trials are needed to determine the most effective clinical interventions for prevention of AMI/AIS following BSI in high risk patients and improve survival after these events.http://www.sciencedirect.com/science/article/pii/S2590086221000045Coronary artery diseaseAcute coronary syndromeCardiovascular diseaseCerebrovascular diseaseBacteremiaSepsis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Vinh-An D. Vo Mazen K. Khalil Majdi N. Al-Hasan |
spellingShingle |
Vinh-An D. Vo Mazen K. Khalil Majdi N. Al-Hasan Risk and clinical outcomes of acute myocardial infarction and acute ischemic stroke following gram-negative bloodstream infection International Journal of Cardiology. Hypertension Coronary artery disease Acute coronary syndrome Cardiovascular disease Cerebrovascular disease Bacteremia Sepsis |
author_facet |
Vinh-An D. Vo Mazen K. Khalil Majdi N. Al-Hasan |
author_sort |
Vinh-An D. Vo |
title |
Risk and clinical outcomes of acute myocardial infarction and acute ischemic stroke following gram-negative bloodstream infection |
title_short |
Risk and clinical outcomes of acute myocardial infarction and acute ischemic stroke following gram-negative bloodstream infection |
title_full |
Risk and clinical outcomes of acute myocardial infarction and acute ischemic stroke following gram-negative bloodstream infection |
title_fullStr |
Risk and clinical outcomes of acute myocardial infarction and acute ischemic stroke following gram-negative bloodstream infection |
title_full_unstemmed |
Risk and clinical outcomes of acute myocardial infarction and acute ischemic stroke following gram-negative bloodstream infection |
title_sort |
risk and clinical outcomes of acute myocardial infarction and acute ischemic stroke following gram-negative bloodstream infection |
publisher |
Elsevier |
series |
International Journal of Cardiology. Hypertension |
issn |
2590-0862 |
publishDate |
2021-03-01 |
description |
Objectives: This retrospective cohort study examines incidence, risk factors, and clinical outcomes of acute myocardial infarction (AMI) and acute ischemic stroke (AIS) within one year of gram-negative bloodstream infection (GN-BSI) based on predefined clinical criteria. Methods: Hospitalized adults with GN-BSI at Prisma Health-Midlands hospitals in South Carolina, USA from 2010 through 2015 were identified. Kaplan-Meier analysis was used to determine incidence of AMI and AIS within one year after GN-BSI. Multivariate Cox proportional hazards regression models were used to examine risk factors for AMI or AIS and impact on 1-year mortality. Results: Among 1292 patients with GN-BSI, 263 and 17 developed AMI and AIS within 1-year with incidences of 23.4% and 1.9%, respectively. Majority of AMI were type 2 (164; 62%); 99 patients had type 1 AMI with incidence of 8.9%. Age >65 years (hazard ratio [HR] 1.52, 95% CI: 1.17–1.99), prior coronary artery disease or stroke (HR 1.74, 95% CI: 1.34–2.25), hypertension (HR 1.55, 95% CI: 1.13–2.15), end-stage renal disease (HR 1.52, 95% CI: 1.09–2.08), and quick Pitt bacteremia score (HR 1.55 per point, 95% CI: 1.40–1.72) were predictors of AMI/AIS. Development of type 1 AMI or AIS after GN-BSI was independently associated with increased 1-year mortality (HR 1.47, 95% CI: 1.03–2.07). Conclusions: AMI and AIS occur frequently within one year of GN-BSI and have negative impact on 1-year survival. Future randomized clinical trials are needed to determine the most effective clinical interventions for prevention of AMI/AIS following BSI in high risk patients and improve survival after these events. |
topic |
Coronary artery disease Acute coronary syndrome Cardiovascular disease Cerebrovascular disease Bacteremia Sepsis |
url |
http://www.sciencedirect.com/science/article/pii/S2590086221000045 |
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