Influenza <-> Myocardial Infarction

Comorbidity A_BEFORE_B CURATED

Directional trajectory: acute influenza is a short-term trigger of acute (type 1) myocardial infarction, with the excess risk concentrated in the first week after infection. The mechanism — systemic inflammation, thromboinflammatory endothelial activation, and a procoagulant shift destabilizing vulnerable coronary plaque — is also captured as a pathophysiology node ("Triggering of Acute Myocardial Infarction") in Influenza.yaml. This entry models the disease-to-disease directional signal.

Disease A

Influenza

Slug:Influenza

Disease B

Myocardial Infarction

Slug:Myocardial_Infarction

Causal Mechanism Graphs

Influenza

graph LR
    Triggering_of_Acute_Myocardial_Infarction["Triggering of Acute Myocardial Infarction"]
    Endothelial_Dysfunction_and_Thromboinflammation["Endothelial Dysfunction and Thromboinflammation"]

    Endothelial_Dysfunction_and_Thromboinflammation --> Triggering_of_Acute_Myocardial_Infarction

    style Triggering_of_Acute_Myocardial_Infarction fill:#dbeafe
    style Endothelial_Dysfunction_and_Thromboinflammation fill:#dbeafe

Myocardial Infarction

graph LR
    Post_Infarction_Inflammation_and_Cardiac_Repair["Post-Infarction Inflammation and Cardiac Repair"]
    Ischemia_Reperfusion_Injury["Ischemia-Reperfusion Injury"]
    Cardiac_Fibrosis_and_Ventricular_Remodeling["Cardiac Fibrosis and Ventricular Remodeling"]
    Myocardial_Ischemia_and_Cardiomyocyte_Death["Myocardial Ischemia and Cardiomyocyte Death"]
    Coronary_Atherothrombosis["Coronary Atherothrombosis"]

    Coronary_Atherothrombosis --> Myocardial_Ischemia_and_Cardiomyocyte_Death
    Myocardial_Ischemia_and_Cardiomyocyte_Death --> Ischemia_Reperfusion_Injury
    Myocardial_Ischemia_and_Cardiomyocyte_Death --> Post_Infarction_Inflammation_and_Cardiac_Repair
    Ischemia_Reperfusion_Injury --> Post_Infarction_Inflammation_and_Cardiac_Repair
    Post_Infarction_Inflammation_and_Cardiac_Repair --> Cardiac_Fibrosis_and_Ventricular_Remodeling

    style Post_Infarction_Inflammation_and_Cardiac_Repair fill:#dbeafe
    style Ischemia_Reperfusion_Injury fill:#dbeafe
    style Cardiac_Fibrosis_and_Ventricular_Remodeling fill:#dbeafe
    style Myocardial_Ischemia_and_Cardiomyocyte_Death fill:#dbeafe
    style Coronary_Atherothrombosis fill:#dbeafe

Association Signals

Signal 1

Population:Self-controlled case series of adults with laboratory-confirmed influenza and hospitalization for acute myocardial infarction, Ontario, Canada.

Temporal: A before B: , B before A: , Same time:

IRR: 6.05

CI: 3.86 - 9.5

FDR:

Incidence ratio of acute MI admission during the 7-day post-influenza risk interval versus the control interval; no excess after day 7.

PMID:29365305 (SUPPORT)

Source: HUMAN_CLINICAL

"The incidence ratio of an admission for acute myocardial infarction during the risk interval as compared with the control interval was 6.05"

Self-controlled case series quantifies a ~6-fold increase in acute MI risk during the 7 days after laboratory-confirmed influenza.

Hypotheses

Acute influenza drives systemic inflammation, endothelial activation, platelet activation, and a procoagulant state that can destabilize vulnerable coronary atherosclerotic plaque and precipitate atherothrombotic coronary occlusion, triggering type 1 myocardial infarction.

PMID:29365305 (SUPPORT)

Source: HUMAN_CLINICAL

"Acute myocardial infarction can be triggered by acute respiratory infections."

States the mechanistic premise that acute respiratory infection, including influenza, can trigger acute myocardial infarction.

Pathophysiology:

Thromboinflammatory plaque destabilization: Influenza-driven inflammation and procoagulant shift promote coronary plaque instability and thrombosis.

Biological processes:

PMID:29365305 (SUPPORT)

Source: HUMAN_CLINICAL

"Acute myocardial infarction can be triggered by acute respiratory infections."

Supports infection-triggered acute MI via inflammatory/thrombotic mechanisms.

Raw YAML

Show YAML

name: com_Influenza__Myocardial_Infarction
creation_date: "2026-06-25T12:00:00Z"
curation_status: CURATED
notes: >-
  Directional trajectory: acute influenza is a short-term trigger of acute
  (type 1) myocardial infarction, with the excess risk concentrated in the
  first week after infection. The mechanism — systemic inflammation,
  thromboinflammatory endothelial activation, and a procoagulant shift
  destabilizing vulnerable coronary plaque — is also captured as a
  pathophysiology node ("Triggering of Acute Myocardial Infarction") in
  Influenza.yaml. This entry models the disease-to-disease directional signal.

disease_a:
  slug: Influenza

disease_b:
  slug: Myocardial_Infarction

directionality: A_BEFORE_B

association_signals:
- source: LITERATURE
  method: EHR_COHORT_ASSOCIATION
  population: >-
    Self-controlled case series of adults with laboratory-confirmed influenza
    and hospitalization for acute myocardial infarction, Ontario, Canada.
  directionality: A_BEFORE_B
  statistics:
    metrics:
    - metric_type: IRR
      metric_value: 6.05
      metric_ci_lower: 3.86
      metric_ci_upper: 9.50
      notes: >-
        Incidence ratio of acute MI admission during the 7-day post-influenza
        risk interval versus the control interval; no excess after day 7.
    evidence:
    - reference: PMID:29365305
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: "The incidence ratio of an admission for acute myocardial infarction during the risk interval as compared with the control interval was 6.05"
      explanation: >-
        Self-controlled case series quantifies a ~6-fold increase in acute MI
        risk during the 7 days after laboratory-confirmed influenza.

hypotheses:
- description: >-
    Acute influenza drives systemic inflammation, endothelial activation,
    platelet activation, and a procoagulant state that can destabilize
    vulnerable coronary atherosclerotic plaque and precipitate atherothrombotic
    coronary occlusion, triggering type 1 myocardial infarction.
  evidence:
  - reference: PMID:29365305
    supports: SUPPORT
    evidence_source: HUMAN_CLINICAL
    snippet: "Acute myocardial infarction can be triggered by acute respiratory infections."
    explanation: >-
      States the mechanistic premise that acute respiratory infection,
      including influenza, can trigger acute myocardial infarction.
  pathophysiology:
  - name: Thromboinflammatory plaque destabilization
    description: >-
      Influenza-driven inflammation and procoagulant shift promote coronary
      plaque instability and thrombosis.
    biological_processes:
    - preferred_term: inflammatory response
      term:
        id: GO:0006954
        label: inflammatory response
    - preferred_term: platelet activation
      term:
        id: GO:0030168
        label: platelet activation
    - preferred_term: blood coagulation
      term:
        id: GO:0007596
        label: blood coagulation
    evidence:
    - reference: PMID:29365305
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: "Acute myocardial infarction can be triggered by acute respiratory infections."
      explanation: Supports infection-triggered acute MI via inflammatory/thrombotic mechanisms.

Source:GitHub