Incidence of UTI High in Patients With Acute Coronary Syndromes

NEW ORLEANS (Reuters Health) – Patients with unstable coronary syndromes are three times more likely to have urinary tract infections (UTIs) than other cardiac patients and the condition may be a trigger for myocardial infarction.
At this year’s American College of Cardiology’s Annual Scientific Session 2004, Dr. John B. Sims of the University of Texas Southwestern Medical Center in Dallas presented findings of a retrospective case-controlled study of 100 consecutive patients at their institution admitted with ACS.
One hundred patients awaiting coronary artery bypass surgery served as controls.
The investigators found that 27% of the ACS patients had subclinical UTIs compared with 11 control patients.
Dr. Sims said that the adjusted odds ratio for UTI in the study group was 2.99. He added that a general search of the medical literature indicates the general prevalence of UTI in the population appear to be in the range of 2% to 10%.
“Subclinical UTI may be a trigger for ACS and MI, perhaps via activation of the inflammatory system,” Dr. Sims speculated. “We think that infection is definitely playing a role here Äin the ACS patientÅ.”
Infectious agents such as Helicobacter pylori and Chlamydia have long been suspects as triggers of acute coronary events, he noted.
Since a urinalysis is part of a routine admissions procedure, Dr. Sims said that physicians need to be alert to the possibility of a UTI in patients presenting with ACS and to treat it promptly.
“Inflammation is involved in ACS, so by treating the UTI, one cause of inflammation can be reduced,” he told Reuters Health.

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