According to new research, a respiratory infection is linked to a four-fold increased risk of in-hospital cardiovascular mortality after acute myocardial infarction.

The current study aimed to evaluate the impact of the development of respiratory infection on in-hospital cardiovascular mortality in patients admitted for AMI. The researchers retrospectively analysed data from 1 907 patients admitted with AMI over a four year period. Respiratory infection was diagnosed based on chest X-ray, and clinical and analytical data. Clinical and laboratory features, treatment and adverse events were compared in patients with and without RI.

During the study period, 117 patients developed RI (6%). RI development was associated with older age, higher diabetes prevalence and a more severe clinical presentation. The development of RI was associated with a worse disease course, longer length of stay, higher Killip Class,3 and higher incidence of malignant arrhythmias, ischaemic stroke and reinfarction along with more frequent need for transfusional, circulatory and respiratory support.

The researchers found that patients with RI had a 6.12 times higher in-hospital cardiovascular mortality than those without RI (95% confidence interval [CI]=3.34-11.21, p<0.001). After adjusting for classical risk factors for cardiovascular mortality (such as age, gender, systolic blood pressure, renal function, NT-proBNP), RI remained an independent predictor of in-hospital cardiovascular mortality with an adjusted odds ratio of 3.93 (95% CI=1.704-9.074, p=0.001).

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