Author Affiliations: Texas Heart Institute, St Luke's Episcopal Hospital, and Baylor College of Medicine, Houston, Texas.
Many clinical studies supported by basic experiments suggest that infections may trigger an acute coronary syndrome. The role of respiratory infections, especially influenza and pneumococcal pneumonia, in acute coronary syndrome in high-risk patients has been well documented.1- 3 Such infections can cause an exaggerated inflammatory response in a high-risk atherosclerotic plaque, which may be followed by destabilization of the plaque, activation of the coagulation cascade, vascular thrombosis, and subsequent myocardial infarction (MI). Given the high prevalence of coronary heart disease and its risk factors in the population and the frequency of influenza and pneumonia, it is likely that each year thousands of patients might develop cardiovascular events after having such infections. This potentially causal effect has immense clinical implications, because it offers a potential method for preventing cardiovascular events by preventing or treating these infections.4
Madjid M, Musher DM. Preventing Myocardial Infarction With VaccinationMyths and Realities. JAMA. 2010;303(17):1751-1752. doi:10.1001/jama.2010.571