graph LR
Triggering_of_Acute_Myocardial_Infarction["Triggering of Acute Myocardial Infarction"]
Immune_competent_microvascularized_lung_on_a_chip_IC_LOC_severe_H1N1_model["Immune-competent microvascularized lung-on-a-chip (IC-LOC) severe H1N1 model"]
Inflammasome_Activation_and_Cytokine_Storm["Inflammasome Activation and Cytokine Storm"]
Respiratory_Epithelial_Infection_and_Cytopathic_Effect["Respiratory Epithelial Infection and Cytopathic Effect"]
Endothelial_Dysfunction_and_Thromboinflammation["Endothelial Dysfunction and Thromboinflammation"]
Endothelial_Dysfunction_and_Thromboinflammation --> Triggering_of_Acute_Myocardial_Infarction
Immune_competent_microvascularized_lung_on_a_chip_IC_LOC_severe_H1N1_model --> Inflammasome_Activation_and_Cytokine_Storm
Immune_competent_microvascularized_lung_on_a_chip_IC_LOC_severe_H1N1_model --> Respiratory_Epithelial_Infection_and_Cytopathic_Effect
Immune_competent_microvascularized_lung_on_a_chip_IC_LOC_severe_H1N1_model --> Endothelial_Dysfunction_and_Thromboinflammation
style Triggering_of_Acute_Myocardial_Infarction fill:#dbeafe
style Immune_competent_microvascularized_lung_on_a_chip_IC_LOC_severe_H1N1_model fill:#ccfbf1
style Inflammasome_Activation_and_Cytokine_Storm fill:#dbeafe
style Respiratory_Epithelial_Infection_and_Cytopathic_Effect fill:#dbeafe
style Endothelial_Dysfunction_and_Thromboinflammation fill:#dbeafe
graph LR
Coronary_Atherothrombosis["Coronary Atherothrombosis"]
Myocardial_Ischemia_and_Cardiomyocyte_Death["Myocardial Ischemia and Cardiomyocyte Death"]
Post_Infarction_Inflammation_and_Cardiac_Repair["Post-Infarction Inflammation and Cardiac Repair"]
Ischemia_Reperfusion_Injury["Ischemia-Reperfusion Injury"]
Total_lipids_in_very_small_VLDL_XS_VLDL_L["Total lipids in very small VLDL (XS-VLDL-L)"]
Cardiac_Fibrosis_and_Ventricular_Remodeling["Cardiac Fibrosis and Ventricular Remodeling"]
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
Coronary_Atherothrombosis -.-> Total_lipids_in_very_small_VLDL_XS_VLDL_L
style Coronary_Atherothrombosis fill:#dbeafe
style Myocardial_Ischemia_and_Cardiomyocyte_Death fill:#dbeafe
style Post_Infarction_Inflammation_and_Cardiac_Repair fill:#dbeafe
style Ischemia_Reperfusion_Injury fill:#dbeafe
style Total_lipids_in_very_small_VLDL_XS_VLDL_L fill:#e0e7ff
style Cardiac_Fibrosis_and_Ventricular_Remodeling fill:#dbeafe
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
reference_title: "Acute Myocardial Infarction after Laboratory-Confirmed Influenza Infection."
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
reference_title: "Acute Myocardial Infarction after Laboratory-Confirmed Influenza Infection."
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
reference_title: "Acute Myocardial Infarction after Laboratory-Confirmed Influenza Infection."
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.