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Risk of acute myocardial infarction and ischemic stroke in patients with asthma exacerbation: A population-based, self-controlled case series study.
J Allergy Clin Immunol Pract. 2019 Jul 16;:
Authors: Raita Y, Camargo CA, Faridi MK, Brown DFM, Shimada YJ, Hasegawa K
Abstract
BACKGROUND: Patients with asthma have a high incidence of acute myocardial infarction and ischemic stroke.
OBJECTIVE: We aim to investigate the acute effect of asthma exacerbation on these cardiovascular events.
METHODS: Using population-based inpatient data of three geographically-diverse U.S. states (Florida, Nebraska, and New York) during 2011-2014, we conducted a self-controlled case series study of adults (aged ≥40 years) hospitalized with asthma exacerbation. The primary outcome was a composite of acute myocardial infarction and ischemic stroke. We used conditional Poisson regression to compare each patient's incidence rate of the outcome during three sequential risk periods (1-7, 8-14, and 15-28 days after asthma exacerbation) with that of reference period (i.e., summed period before and after the three risk periods).
RESULTS: We identified 4,607 adults hospitalized for asthma exacerbation who had a first episode of acute myocardial infarction or ischemic stroke. During the reference period, the incidence rate of acute myocardial infarction or ischemic stroke was 25.0/100 person-years. Compared with the reference period, the incidence rate significantly increased during the first risk period (129.1/100 person-years), with a corresponding adjusted incidence rate ratio (aIRR) of 5.04 (95%CI, 4.29-5.88; P<0.001). In the two subsequent risk periods, the incidence rate declined but remained high-50.1/100 person-years (aIRR 1.96; 95%CI, 1.51-2.48; P<0.001) and 38.0/100 person-years (aIRR, 1.48; 95%CI, 1.20-1.81; P<0.001), respectively. The findings were similar when the two outcomes were examined separately.
CONCLUSIONS: In this population-based study of adults with asthma, the risk of acute myocardial infarction and ischemic stroke increased significantly after asthma exacerbation.
PMID: 31323338 [PubMed - as supplied by publisher]