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O048 - THE RISK OF ACUTE MYOCARDIAL INFARCTION INCREASES SUBSTANTIALLY DURING LABORATORY-CONFIRMED INVASIVE PNEUMOCOCCAL DISEASE: A SELF-CONTROLLED CASE SERIES ANALYSIS (ID 730)
Abstract
Background
Major cardiovascular events, including acute myocardial infarction (AMI), have been reported among patients with invasive pneumococcal disease (IPD). Yet, whether IPD is causally associated with AMI remains unclear. We sought to determine if laboratory confirmed IPD was associated with the risk of AMI.
Methods
We conducted a self-controlled case series (SCCS) analysis among adult Tennessee residents with evidence of laboratory confirmed IPD as identified by the Tennessee Active Bacterial Core surveillance system (2003-2019). Patients entered the cohort 52 weeks prior to their IPD specimen collection date and were followed through the earliest of date of death, week 52 after IPD or end of study (12/2019). Risk periods included a pre-IPD (day -7 to day -1 before IPD date), an acute IPD (day 0 to 7 after IPD date), a post-acute IPD (day 8 to 28 after IPD date) and a control (all other follow-up time) risk period. We used conditional Poisson regression to perform within-person comparisons and to calculate age-adjusted incidence rate ratios for each risk period compared to control periods.
Results
Among 3,140 patients with laboratory confirmed IPD, 13.9% (n=438) had an AMI episode during follow-up. The incidence of AMI was significantly higher during both the pre-IPD (IRR: 8.3; 95% CI: 5.6-12.4) and the acute IPD (IRR: 47.7; 95% CI: 37.5-60.9) risk periods compared to control periods. No difference was observed for the post-acute IPD risk period.
Conclusions
The risk of AMI was substantially increased during laboratory confirmed IPD periods compared to control periods.