Outcome-Based Comparison of Patients with Myocardial Infarction with and Without Respiratory Tract Infections

Hira  Choudhary; Muhammad Usama  Zamir; Muhammad Imtiaz  Malik

doi:10.54112/bcsrj.v6i5.1764

Authors

Hira Choudhary Department of Medicine, Fauji Foundation Hospital, Lahore, Pakistan
Muhammad Usama Zamir Department of Medicine, Fauji Foundation Hospital, Lahore, Pakistan
Muhammad Imtiaz Malik Department of Medicine, Fauji Foundation Hospital, Lahore, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v6i5.1764

Keywords:

Myocardial Infarction, Respiratory Tract Infection, Heart Failure, Comorbidity, Inflammation

Abstract

Myocardial infarction (MI) remains a leading cause of morbidity and mortality globally. Coexisting systemic conditions such as respiratory tract infections (RTIs) may worsen clinical outcomes due to heightened inflammatory and metabolic stress. Objective: To compare in-hospital outcomes of patients with MI in the presence and absence of concurrent respiratory tract infections. Methods: This comparative cross-sectional study was conducted at Fauji Foundation Hospital, Lahore from 10 August 2024 to 15 March 2025. A total of 455 patients admitted with a confirmed diagnosis of MI were enrolled over the study period using a non-probability consecutive sampling technique. All patients aged 18 years and above who were diagnosed with ST-elevation myocardial infarction (STEMI) or non-ST-elevation myocardial infarction (NSTEMI), based on clinical presentation, electrocardiographic findings, and elevated cardiac biomarkers (troponin I/T or CK-MB), were eligible for inclusion. Results: Patients with RTIs were older and had higher rates of diabetes and hypertension (p < 0.05). In-hospital mortality was significantly higher in the RTI group (16.1% vs. 7.3%, p = 0.006), with longer hospital stays (7.4 ± 2.6 vs. 5.6 ± 2.1 days, p < 0.001), greater ICU admissions (32.1% vs. 14.6%, p < 0.001), and more frequent mechanical ventilation (19.6% vs. 6.1%, p < 0.001). RTI patients also had increased incidence of acute heart failure (29.5% vs. 17.2%, p = 0.004) and arrhythmias (22.3% vs. 13.1%, p = 0.01). On multivariate analysis, RTI was an independent predictor of in-hospital mortality (AOR: 2.38; 95% CI: 1.25–4.51) and ICU admission (AOR: 2.91; 95% CI: 1.73–4.91). Conclusion: It is concluded that concurrent respiratory tract infections in patients with myocardial infarction are associated with significantly poorer in-hospital outcomes. These findings emphasize the importance of early recognition, aggressive management, and possibly preventive strategies such as vaccination in MI patients at risk of infection.

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