Gastroenteritis promotes the development of systemic
inflammation and a hypercoagulable state. There are limited data regarding the association between
gastroenteritis and acute
myocardial infarction (AMI). We aimed to evaluate the risk of AMI after an episode of
gastroenteritis. In this nested case-control study, we selected patients who were hospitalized for AMI (N = 103,584) as a case group during 2010-2017 and performed propensity score matching (case-control ratio 1:1) to select eligible controls from insurance research data in Taiwan. We applied multivariable logistic regressions to calculate adjusted odds ratios (
ORs) with 95% confidence intervals (CIs) for the risk of AMI associated with recent
gastroenteritis within 14 days before AMI. We also compared the outcomes after AMI in patients with or without
gastroenteritis. A total of 1381 patients (1.3%) with AMI had a prior episode of
gastroenteritis compared to 829 (0.8%) among the controls.
Gastroenteritis was significantly associated with a subsequent risk of AMI (adjusted OR: 1.68, 95% CI: 1.54-1.83), which was augmented in hospitalizations for
gastroenteritis (adjusted OR: 2.50, 95% CI: 1.20-5.21). The outcomes after AMI were worse in patients with
gastroenteritis than in those without
gastroenteritis, including increased 30-day in-hospital mortality (adjusted OR: 1.28, 95% CI: 1.08-1.52), medical expenditure, and length of
hospital stay.
Gastroenteritis may act as a trigger for AMI and correlates with worse post-AMI outcomes. Strategies of aggressive hydration and/or increased antithrombotic
therapies for this susceptible population should be further developed.