European Heart Journal Advance Access originally published online on April 17, 2007
European Heart Journal 2007 28(10):1205-1210; doi:10.1093/eurheartj/ehm035
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Influenza epidemics and acute respiratory disease activity are associated with a surge in autopsy-confirmed coronary heart disease death: results from 8 years of autopsies in 34 892 subjects
1 The University of Texas Health Science Center at Houston, Houston, TX, USA
2 Texas Heart Institute, 6770 Bertner, MC 2-255, Houston, TX 77030, USA
3 Influenza Research Institute, St. Petersburg, Russian Federation
4 St Petersburg Medical Academy of Postgraduate Education, St Petersburg, Russian Federation
Received 16 August 2006; revised 15 February 2007; accepted 23 February 2007; online publish-ahead-of-print 17 April 2007.
* Corresponding author. Tel: +1 832 355 9330; fax: +1 832 355 9595. E-mail address: mohammad.madjid{at}uth.tmc.edu
See page 1178 for the editorial comment on this article (doi:10.1093/eurheartj/ehm073)
Aims: To determine whether influenza can trigger heart attacks, we investigated the impact of influenza epidemics on autopsy-proven coronary deaths.
Methods and results: We studied weekly death due to acute myocardial infarction (AMI) and chronic ischaemic heart disease (IHD) in autopsies conducted in 1993 to 2000 in St Petersburg, Russia. We plotted the weekly acute respiratory disease (ARD) counts and influenza epidemics against AMI and chronic IHD deaths. There were 11 892 subjects dying of AMI and 23 000 subjects dying of chronic IHD. Median age was 75 for women and 65 for men. In every year, a peak of AMI and chronic IHD deaths were present and coincided with the influenza epidemic and peak ARD activity. A similar pattern was seen for each subgroup of men, women, subjects 50 years or older, and subjects 70 years or older. When comparing the average influenza epidemic weeks to average off-season weeks, the odds for AMI and chronic IHD death increased by 1.30 (95% confidence interval (CI): 1.08–1.56) and 1.10 (95% CI: 0.97–1.26), respectively.
Conclusion: Influenza epidemics are associated with a rise in autopsy-confirmed coronary deaths. Influenza vaccination should be advocated for patients at high risk of developing cardiovascular events.
Key Words: Influenza • Myocardial infarction • Trigger • Cardiac death • Infection • Epidemiology
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