Evidence map›Paper›PMID 40588386›Full record

ArticleBMJ open2025

Risk of myocardial infarction and stroke following microbiologically confirmed urinary tract infection: a self-controlled case series study using linked electronic health data.

Nicola F Reeve, Victoria Best, Rebecca Cannings-John, David Gillespie, Kathryn Hughes, Fiona V Lugg-Widger, Fatemeh Torabi, Mandy Wootton, Ashley Akbari, Haroon Ahmed

Abstract read
In one paragraph

Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Stroke, infections, and New Mechanisms: a Narrative Review.Current neurology and neuroscience reports · 2025
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Nicola F ReeveCardiff University, Cardiff, UK reeven1@cardiff.ac.uk.ORCID http://orcid.org/0000-0001-9602-6675
Victoria BestSwansea University, Swansea, UK.
Rebecca Cannings-JohnCardiff University, Cardiff, UK.ORCID http://orcid.org/0000-0001-5235-6517
David GillespieCardiff University, Cardiff, UK.ORCID http://orcid.org/0000-0002-6934-2928
Kathryn HughesCardiff University, Cardiff, UK.
Fiona V Lugg-WidgerCardiff University, Cardiff, UK.ORCID http://orcid.org/0000-0003-0029-9703
Fatemeh TorabiSwansea University, Swansea, UK.ORCID http://orcid.org/0000-0002-5853-4625
Mandy WoottonPublic Health Wales, Cardiff, UK.
Ashley AkbariCardiff University, Cardiff, UK.ORCID http://orcid.org/0000-0003-0814-0801
Haroon AhmedCardiff University, Cardiff, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThe inflammatory response from acute infection may trigger cardiovascular events. We aimed to estimate associations between microbiologically confirmed urinary tract infections (UTIs) and first acute myocardial infarction (MI) and stroke.

designWe used a self-controlled case series, with risk periods 1-7, 8-14, 15-28 and 29-90 days after UTI. Included individuals experienced the outcome and exposure of interest and acted as their own controls.

settingWe used individually linked general practice, hospital admission and microbiology data for the population of Wales held by the Secure Anonymised Information Linkage databank.

participantsIncluded individuals were Welsh residents aged over 30 years with a record of a hospital admission for MI or stroke (outcomes) and evidence of a microbiologically confirmed UTI (exposure) during the study period of 1 January 2010 to 31 December 2020.

main outcome measuresThe primary outcome was acute MI or stroke identified using the International Classification of Disease V.10 codes from inpatient diagnoses recorded in the Patient Episode Database for Wales. We used Poisson regression to estimate incidence rate ratios (IRRs) and 95% CIs for MI and stroke during predefined risk periods, compared with baseline periods.

resultsDuring the study period, 51 660 individuals had a hospital admission for MI, of whom 2320 (4.5%) had 3900 microbiologically confirmed UTIs, and 58 150 had a hospital admission for stroke, of whom 2840 (4.9%) had 4600 microbiologically confirmed UTIs. There were 120 MIs during risk periods and 2190 during baseline periods, with an increased risk of MI for 1-7 days following UTI (IRR 2.49, 95% CI (1.65 to 3.77)). There were 200 strokes during risk periods and 2640 during baseline periods, with an increased risk of stroke for 1-7 days following UTI (IRR 2.34, 95% CI (1.61 to 3.40)).

conclusionsUTI may be a trigger for MI or stroke. Further work is needed to understand mechanisms and test interventions to reduce the risk of cardiovascular events among people with UTIs in primary care.

Indexed as

Myocardial InfarctionStrokeUrinary Tract InfectionsAdultAgedAged, 80 and overCase-Control StudiesElectronic Health RecordsFemaleHospitalizationHumansIncidenceMaleMiddle AgedRisk FactorsWalesCardiologyMyocardial infarctionStrokeUrinary tract infections

Identifiers

PMID40588386
PMCPMC12211855

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.