11 ms·
Myocardial infarction may be an infectious disease
Paper: https://www.ahajournals.org/doi/10.1161/JAHA.125.041521 https://www.ahajournals.org/doi/10.1161/JAHA.125.041521
- tsoukase 1y agoArterial plaque is a long standing, foreign body without vessels causing high flows. No surprise it can be infected by bacteria sometime. That is infection can exacerbate the MI, not cause it.
- tempera 1y ago[dead]
- andy99 1y agoThe original title is "Myocardial infarction may be an infectious disease" which appears to be clickbait, with the title posted here being much more accurate. Immune response to bacteria in arterial plaques can cause them to break up and cause the attack (my lay-interpretation) so the bacteria is a trigger, but "infectious disease" is a bit of hyperbole.
- JumpCrisscross 1y ago> bacteria in arterial plaques can cause them to break up and cause the attack “Dormant bacteria within the biofilm remain[ing] shielded from both the patient’s immune system and antibiotics because they cannot penetrate the biofilm matrix” whose rupture “result[s] in thrombus formation and ultimately myocardial infarction” sounds like infection more than careless bacteria kicking up muck.
- Supermancho 1y agoNot all infarctions are due to infectious disease. The title (even on HN) is incorrect. "Some myocardial infarctions attributed to an infectious disease." "A myocardial infarction may be due to infectious disease." My maternal grandfather died of an aortic separation. This caused a myocradial infarction, which was not due to infectious disease. I had my aortic valve replaced with a mechanical when I was 2, and 9, and 31, so I'll have a more nuanced kind of heart failure.
- DaveZale 1y agoArnold Schwatzenegger also has a congenital history, a few heart surgeries..
- Supermancho 1y agoGaining a ton of body mass working out thickens the heart. It's necessary to push the blood into veins that get constricted, more and more with increased weight. In the epilogue, as you get older, optimal function fades. The thickened tissue isn't as elastic, compounding cardiac problems and sometimes causing infarction (also, not infectious related). Ironically, a thickened heart gives you better odds at surviving surgery, due to the excess tissue and the minimal effect of scarring already-rigid tissue. Some people see heart walls thinning at a very ripe age (90s+) but for most early heart patients, they don't make it that far.
- tbrownaw 1y agoI assume this is a "here's another way this can happen" rather than "actually this is caused only by this and not by what we used to think"?
- lostlogin 1y agoSurely this? The number of ‘oh, it turned out to be more more complicated’ scenarios in medicine is high.
- tialaramex 1y agoOf course it depends on fractions. You can develop cervical cancer via some other route, but the vast, vast majority of cervical cancers are caused by HPV infection. So knowing that all the plans towards eliminating this disease focus on HPV. On the other hand most people with "flu" in summer months are not infected with Influenza, so an improved influenza treatment isn't going to make a big difference for them unlike in winter. We know other reasons you might get those symptoms which are more likely in summer.
- dredmorbius 1y agoPeptic ulcers are another well-known case, in which most (though not all) instances can be traced to a Helicobacter pylori infection. Other causal factors include NSAID usage, stress, and diet. <https://en.wikipedia.org/wiki/Peptic_ulcer_disease https://en.wikipedia.org/wiki/Peptic_ulcer_disease> <https://en.wikipedia.org/wiki/Timeline_of_peptic_ulcer_disease_and_Helicobacter_pylori https://en.wikipedia.org/wiki/Timeline_of_peptic_ulcer_disea...> One of the rare examples of a mental health condition being virtually completely eliminated is that of General paresis of the insane, a symptom of late-stage syphilis. Successful treatment and elimination of syphilis in patients and populations through antibiotics. As one of the few cases of near-total elimination of a class of mental conditions, this a useful reminder to the psychiatric profession that not all mental conditions have causes limited to the brain and its function, whether through its biochemistry or neural/behavioural processes. <https://en.wikipedia.org/wiki/General_paresis_of_the_insane https://en.wikipedia.org/wiki/General_paresis_of_the_insane>
- op00to 1y agoThis seems like a good explanation of how my father died. He had the flu, and died overnight from a massive heart attack.
- DaveZale 1y agosure does. chain of events. The epidemiologists should be able to validate these claims.
- awesome_dude 1y agohttps://www.health.harvard.edu/heart-health/what-does-the-flu-have-to-do-with-the-heart https://www.health.harvard.edu/heart-health/what-does-the-fl... How does flu affect the heart? The virus only rarely infects the heart directly. Instead, the adverse effects of the virus on the heart are due to atherosclerosis of the arteries of the heart. Many people over age 50 have atherosclerosis — and in some people it has not yet been diagnosed. Because atherosclerosis narrows the arteries and reduces the flow of blood, less oxygen reaches the heart muscle. When the effect of the flu on the lungs lowers the amount of oxygen in the blood, this further reduces the supply of oxygen to the heart. This can lead to a heart attack or cardiac arrest (sudden death). Is this risk more than theoretical? Many careful studies have shown there is an increased risk of heart disease following a bout of flu. In one study of 80,000 adults with influenza, nearly 12% had a serious cardiac event, such as a heart attack, during or in the weeks after getting the flu.
- op00to 1y agoFor sure it exacerbated an existing cardiovascular system. Once the system is weakened things cause big problems quickly.
- y1n0 1y agoIn the context of the article, it's inflammation rupturing the 'fibrous cap' on plaque deposits leading to a heart attack, so I presume OP is talking about the inflammatory response to having the flu.
- smt88 1y ago
- brandonb 1y agoThis is a nicely-designed study. For decades, we've known that inflammation is a risk factor for heart attacks. In this study, the researchers designed a custom antibody that binds to oral bacteria. Then they used histological staining to identify specific biofilm structures inside the atherosclerotic tissue. Bacteria released from the biofilm were observed in heart attack cases, which gives us evidence that when the body's immune system responded to these bacteria, it triggered inflammation which ruptured cholesterol-laden plaque. So now we have more insight into the mechanism behind why inflammation is associated with heart attack risk. The "pantheon" of risk factors for heart disease are: * hs-CRP (inflammation): the mechanism studied by this research. High inflammation roughly doubles your risk of heart disease. * ApoB - 20% of people with normal cholesterol will have abnormal ApoB, and be at risk of heart disease (ApoB is a structural protein in lipoproteins which cause arterial plaque). * Lp(a) - the strongest hereditary risk factor for heart disease (Lp(a) acts as a multiplier on ApoB, since it camouflages cholesterol particles from your liver) * HbA1c - insulin resistance /diabetes is a risk factor for just about everything. * eGFR - estimates the volume of liquid your kidneys can filter, and is an input to the latest heart disease risk models (PREVENT). All of these risk factors can be measured with a blood test + doctor review. Easy to order online: https://www.empirical.health/product/comprehensive-health-panel https://www.empirical.health/product/comprehensive-health-pa...
- cameronh90 1y agoFor what it's worth, I did one of these sorts of heart health blood panels, which showed everything as fine except for hs-CRP which was something like 8x what it should be. I took it to the doctor, doctor just shrugged it off and said it's probably fine and I might have just been fighting off a cold.
- DaveZale 1y agoare you a cardiologist? Excellent points, thanks
- brandonb 1y agoNot a cardiologist, but adjacent to this type of research. I'm an MLE but have published research in cardiology.
- neehao 1y agosee https://pubmed.ncbi.nlm.nih.gov/17420199/ https://pubmed.ncbi.nlm.nih.gov/17420199/
- JumpCrisscross 1y ago“Dormant bacteria within the biofilm remain[ing] shielded from both the patient’s immune system and antibiotics because they cannot penetrate the biofilm matrix…” Phages can penetrate biofilms [1]. (They have practice.) [1] https://pmc.ncbi.nlm.nih.gov/articles/PMC8875263/ https://pmc.ncbi.nlm.nih.gov/articles/PMC8875263/
- jimbo808 1y agoBut you can't patent phages, so we'll just continue ignoring them
- JumpCrisscross 1y ago> you can't patent phages, so we'll just continue ignoring them Nope. Plenty of governments fund this sort of research. And chances are there isn’t an off-the-shelf phage that ticks the boxes, which means you need some amount of genetic engineering, in which case Monsanto has your back.
- XorNot 1y ago"simple, obvious and wrong". Phages are intensely species specific to bacterial species, so they don't work unless you identify exactly what you're targeting. Also, even if they can penetrate biofilms, that doesn't mean you can successfully deliver them to the biofilm in the human body, since they have to survive the whole blood stream and the normal human immune response to "not self" things.
- dredmorbius 1y agoAdding to this: a chief advantage of antibiotics (particularly the early ones) is that they were both broad-spectrum (controlling a vast array of bacteria) and sparing of non-bacterial cells (e.g., those of our own bodies). Evolved resistance is changing at least the first part of that relationship. Phages as you note are far more tailored, and may (if I understand correctly) need to be targeted to a patient's specific infection's genetic line. It's as if you had to select ammunition based on the specific type of target you were hunting, if not specific individuals. In the early days of antibiotics it was far more a case of "fire and forget" with a single magic bullet. (Not literally always, but for the overwhelming majority of bacterial infections.)
- A_D_E_P_T 1y agoThis raises two questions. - Does this suggest that courses of antibiotics might reduce heart attack risk? - Does this suggest that regular use of, e.g., Listerine might reduce heart attack risk? (While, perhaps, slightly increasing esophageal cancer risk.) It would be interesting to run an epidemiological study to see if current interventions move the needle in a meaningful way.
- syntaxing 1y agoI probably should find sources first but I was always under the impression that the mouth biome is strongly correlated to gut biome which strongly correlated to immune system.
- prmph 1y agoListerine would make it worse for sure. Don't use "antiseptic" mouthwash; it kills beneficial bacteria in the mouth, causing bad bacteria to multiply. I have personal experience of this.
- dionian 1y agoagreed, after much research the only mouth wash i use is therasol
- tim333 1y agoYes, there are studies where they compared heart attack rates for people who'd taken a course of antibiotics with those who hadn't and there was quite a large effect in some of them. eg. https://www.science.org/content/article/antibiotics-cut-heart-attack-risk https://www.science.org/content/article/antibiotics-cut-hear...
- ygouzerh 1y agoFor the Listerine part: they are referencing this study: https://pubmed.ncbi.nlm.nih.gov/16373688/ https://pubmed.ncbi.nlm.nih.gov/16373688/ that seems to show a correlation between poor oral health and sudden cardiac death, so it might help indeed, with other good oral health practices.
- jimbo808 1y agoThis has been suspected for decades. https://www.thelancet.com/journals/laninf/article/PIIS1473309901001682/abstract https://www.thelancet.com/journals/laninf/article/PIIS147330... Hopefully it leads somewhere that brings us new preventative care.
- ImHereToVote 1y agoMight explain why some have success with carnivore. Less dental plaque.
- banthegays 1y ago[dead]
- faangguyindia 1y agoWasn't that a plot in DBZ where a virus weakens Goku's heart?
- jondwillis 1y agohttps://dragonball.fandom.com/wiki/Heart_Virus https://dragonball.fandom.com/wiki/Heart_Virus Indeed!
- thor-rodrigues 1y agoAnecdotally, I had a myocardial infarction at 23, and I was honestly surprised to learn that it wasn’t already well known that infectious diseases could trigger such events. Up until that point, I’d never had any heart-related issues, nor does anyone in my family. Just two days before being admitted to the hospital with a suspected heart attack, I came down with food poisoning. It wasn’t pleasant, of course, but I thought it was nothing unusual—something a couple of days of rest and hydration would normally resolve. Since my bloodwork at the hospital matched the expected results for a heart attack, and I underwent surgery, the doctors understandably focused on treating the immediate problem rather than identifying the underlying cause (I’m eternally grateful to the team and staff at St. Vincentius-Kliniken. I truly don’t think I’d be here without them). That said, I’m glad to see this area receiving more attention. Hopefully, it will lead to further studies and the development of better strategies for prevention and treatment.
- n8henrie 1y agoCan you clarify -- if you're comfortable sharing additional details -- did you have an "occlusion MI" heart attack, involving balloons / stents in the cath lab? Most people assume that "heart attack" is a distinct clinical entity, but the majority (~80%) of elevated troponin levels are not exactly what comes to mind when people say "heart attack," but will often be described to patients as a heart attack (sometimes out of ignorance and others out of convenience, as the actual explanation for what is going on takes a lot more time and effort).
- _heimdall 1y agoTitles like this are very confusing. The paper better explains it, but a disease can't be contagious or infectious. The paper describes a link between a potential bacterial infection and myocardial infarctions that may take years or decades to develop. The disease is only the named group of symptoms. The potential cause of the disease is the bacterial infection. Those are very different concepts.
- dogmatism 1y agoThe bacterial contribution to MACE has been an ongoing subject of investigation for decades https://www.nejm.org/doi/full/10.1056/NEJMoa043526 https://www.nejm.org/doi/full/10.1056/NEJMoa043526 still hasn't really panned out
- deleted 1y ago[deleted]
- liveoneggs 1y agoThere are already pretty serious blood disorders linked directly to oral health (https://en.wikipedia.org/wiki/Actinomycosis https://en.wikipedia.org/wiki/Actinomycosis almost took down slackware linux) I think I'll go floss.
- DaveZale 1y agoyeah and dehydration is not good, saliva flow is protective
- duffpkg 1y agoThe article differs substantively from the actual conclusions of the study. This study shows a minor correlation in some bacterial DNA "signatures" in arterial plaque in about 200 people (~40% had the correlated bacteria). The study only included tissues from people who died of heart disease or had surgery related to heart disease. There does not currently appear to be a strong baseline about how widespread this bacterial signature may exist in a broad population regardless of health. In a nutshell there is a slightly interesting idea that deserves further study. That's it.
- DaveZale 1y agoyes from tfa: What Question Should Be Addressed Next? • Could a short‐term antibiotics treatment given at the acute phase affect the outcome of myocardial infarction, and would it be possible to develop new diagnostic imaging and prevention methods for bacterial biofilm?
- lithocarpus 1y agoI think the first question to be addressed should be, does the general population have similar prevalence of this bacteria? I didn't read the article but just based on the parent comment, it sounds like this baseline hasn't yet been established. It seems very wrong to start testing antibiotics without first establishing the baseline of whether everyone has this bacteria.
- DaveZale 1y agoanother possibility that was floated in the TFA was vaccination. The whole point of the article was to precisely map out a mechanism, beyond that, many possibilities exist for intervention or prevention.
- lithocarpus 1y agoInteresting. So, one could make a similar article saying "Myocardial infarction may be caused by sugar consumption" and support it by analyzing the recent diet of 200 people who died of heart disease and finding that 95% of them recently consumed a lot of sugar.
- imperfect_light 1y agoHave always been fascinated with Paul Ewald's arguments (as laid out in his books The New Germ Theory of Disease and Evolution of Infectious Disease) that most chronic illnesses are due to pathogens.
- prmph 1y agoInteresting, I'm noticing this pattern too more and more. The classic case was of course stomach ulcers. Now cardiovascular. Wouldn't be surprised if at least some neuro-degnerative diseases are also possibly caused by infections
- imperfect_light 1y agoNow we're seeing more colon cancer in young people. All of the discussion is around factors that change slowly (diet, alcohol, exercise), no one I've heard has pointed out that a pathogen would explain a quick change.
- p1dda 1y agoTypical of the medical field: one of the most studied diseases in the past several decades and now there is a ground-breaking new study that questions all knowledge. I blame the corruption from American medical experts and organizations which only object is to sell drugs.
- KempyKolibri 1y agoIn what sense does it “question all knowledge”?
- lucaslazarus 1y agoThis idea is not supported by the study in question. Even if it were, what you’re describing is just how science works! The cynicism, while understandable, seems widely irrelevant here.
- epcoa 1y agoThis does not question all knowledge. Bacteremia and cardiac disease have been linked for years (see upvoted comment above), which is why these studies were done in the first place. This study isn't ground breaking, it's extending an already established area of study. Furthermore, while there are issues of misaligned incentives across the industry, of the top 10 pharma companies: Roche, AstraZeneca, Bayer, Novartis, Sanofi, Novo Nordisk, GSK, are all based in Europe, so your assertion further down makes no sense.
- anotherpaul 1y ago"The most unique finding in our study was that viridans streptococci seemed to colonize the lipid core and wall of an atheroma as a biofilm and that this biofilm was not recognized by cells of the innate immune system. " This is a pretty cool finding. Biofilms are also beyond reach of antibacterials usually. And seing a commensal become a problem due to "location, location, location" is also cool. Nice article. Cool leads
- atombender 1y agoStreptococcus pyogenes (group A streptococci) are well known for being able to form this kind of biofilm [1] and stay hidden from the immune system. Chronic strep throat (sometimes leading to guttate psoriasis) are thought to be due to this feature. The bacteria can form these biofilms in many places, including the tonsils. It's implicated in things like periodontitis. (Another streptococcus, S. mutans, causes cavities.) They're very sneaky bacteria, due to what's called molecular mimicry. The bacterial surface has a protein called M protein, and some of this protein's epitopes (stretches of amino acids) are the same or similar to human proteins like myosin, similar enough that antibodies cause cross-reactivity with human tissue. This is why strep bacteria can cause rheumatic fever and some other diseases. Strep has also been implicated in psoriasis; we have good evidence that the cross-reactivity is what kick-starts the disease and is in some way responsible for why it's chronic. [1] https://www.ncbi.nlm.nih.gov/books/NBK587105/ https://www.ncbi.nlm.nih.gov/books/NBK587105/
- scloudfox 1y agoGreat concept..
- onesandofgrain 1y agoThis has been known for at least 5 years though, but good to see this topic resurface
- Traubenfuchs 1y agoIt's been known for many years that the flu vaccine reduces heart attack incidence. The flu either causes lasting damage to the cardiovascular system or directly causes heart attacks. This is perfectly well known and absolutely nothing new. This study merely expands research on the topic (focus on bacteria+biofilm instead of flu). So "Myocardial infarction may be an infectious disease" is a weird clickbait title. We know. We knew for a long time. We also have quite a few of anti biofilm agents in IV formulations that could have an effect inside of the cardiovascular system if used in high dosages, but the molecules are old, cheap and unsexy, so no one will try. (ambroxol and NAC come to mind)
- th0ma5 1y agoWild I see only one mention of COVID so far, it has been shown to attack all kinds of organ tissues, the perspectives around "with or from" somehow permanently prevents people from discussing the underlying changes from this continued global cycling of the pathogen.