Risk of myocardial infarction and stroke following bloodstream infection: a population-based self-controlled case series.

Summary

Using a self-controlled case series in population-scale EHRs, BSI triggered a marked, time-limited increase in MI and stroke risk, peaking in the first week and normalizing by 28 days. Risk was substantially higher among those with maximal CRP >300 mg/L, indicating an inflammation-graded effect.

Key Findings

• In the first 1–7 days after BSI, MI risk rose sharply (adjusted IRR 9.67, 95% CI 6.54–14.3) and returned to baseline by 28 days.
• Stroke risk was similarly elevated in the early period after BSI.
• Patients with maximal CRP >300 mg/L had the greatest risk increases (MI IRR 21.54; stroke IRR 6.94).

Clinical Implications

Clinicians should intensify cardiovascular monitoring (e.g., ECG/troponin when symptomatic, BP control) in the first 1–2 weeks after BSI, especially with high CRP. Research into targeted anti-inflammatory or antithrombotic strategies during this window is warranted.

Limitations

• Reliance on ICD-10 coding and timing may introduce misclassification.
• Observational design precludes causal inference; out-of-hospital events not captured.

Future Directions

Evaluate targeted anti-inflammatory or antithrombotic interventions during the high-risk window post-BSI and validate risk stratification incorporating CRP and clinical factors.