Abstract 17546: Role of Infections in Cardiovascular Mortality: Insights from National Health and Nutrition Examination Survey-III

Abstract

Background: The role of infections in the pathogenesis of atherosclerosis and cardiovascular mortality (CM) is controversial. We assessed the prognostic significance of infectious disease burden on CM on a cross sectional US population.

Methods: The study population consisted of all adults >18 yo with available data on infection markers, enrolled into NHANES III (1988 to 1994). This self-weighting sample is representative of US population of 51,042,265 individuals with a mean follow-up period of 14.82 ± 3.92 years/patient. Infectious markers used for the analysis in this study included antibodies to Toxoplasma, Cytomegalovirus, Toxocara, Hepatitis E, Hepatitis B (acute or chronic), Hepatitis C, Herpes 1 or 2, Helicobacter pylori and Human Herpesvirus 8. CM was linked to the National Death Index and based on ICD-10. We divided the subjects into quartiles based on number of infectious markers present; 0-2, 3, 4 and 5-8 markers for each quartile. (Table 1).

Results: Our dataset consisted of 5008 subjects with mean age of 45.12 ± 19.22 years (47.59% men and 89% whites) and total follow up for 74226.75 person years. On multivariate analysis none of the quartiles were found to be significantly associated with CM after controlling for cardiovascular risk factors (See Table).

Conclusion: We found no significant association between the burden of infections and CM over long term follow-up in this cross-sectional United States population. The relationship between infections and CM merits further scientific investigations.