Severe infections and subsequent delayed cardiovascular disease

Abstract

Background Severe infections in adulthood are associated with subsequent short-term cardiovascular disease. Whether hospital admission for sepsis or pneumonia is associated with persistent increased risk (over a year after infection) is less well established. Design The design of this study was as a register-based cohort study. Methods Some 236,739 men born between 1952-1956 were followed from conscription assessments in adolescence to 2010. All-cause cardiovascular disease ( n = 46,754), including coronary heart disease ( n = 10,279) and stroke ( n = 3438), was identified through national registers 1970-2010 (at ages 18-58 years). Results Sepsis or pneumonia in adulthood (resulting in hospital admission) are associated with increased risk of cardiovascular disease in the years following infection. The risk is highest during the first year after the infection, with an adjusted hazard ratio (and 95% confidence intervals) of 6.33 (5.65-7.09) and a notably increased risk persisted with hazard ratios of 2.47 (2.04-3.00) for the second and 2.12 (1.71-2.62) for the third year after infection. The risk attenuated with time, but remained raised for at least five years after infection; 1.87 (1.47-2.38). The results are adjusted for characteristics in childhood, cardiovascular risk factors and medical history in adolescence. Similar statistically significant associations were found for coronary heart disease and stroke. Conclusions Raised risks of cardiovascular disease following hospital admission for sepsis or pneumonia were increased for more than five years after the infection, but with the highest magnitude during the first three years following infection, suggesting a period of vulnerability when health professionals and patients should be aware of the heightened risk for cardiovascular disease.

An observational study of community‐acquired severe sepsis comparing intensive care and non‐intensive care patients

“…We have not found specific investigations on sepsis patients with pre-existing cardiovascular disease. However, there are currently focus on cardiovascular events in sepsis survivors, which comes up as one of the major reasons for their increased long-term risk of death [202][203][204].…”

“…Analogue to their high long-term mortality, sepsis survivors are invariably found to carry more comorbidity than controls. They have a higher occurrence of cardiovascular events [202][203][204], cognitive impairment and functional disability [150], and approximately 60% experience a new hospitalization during the first year after sepsis discharge, most often due to infection [167]. The underlying biological mechanisms for the increased morbidity and accelerated mortality are currently not established.…”

Cardiovascular Events after Community-Acquired Pneumonia: A Global Perspective with Systematic Review and Meta-Analysis of Observational Studies

“…Myocardial infarction, heart failure, arrhythmias and 2 of 23 stroke were witnessed to increase following a CAP episode [7]. The risk is maximal during the acute phase but persists in time after the infection has abated [8]. Moreover, a higher likelihood of a poorer outcome in a patient with CAP complicated by a CV event exists when compared to one with an uncomplicated course [7].…”

Predicting coronary artery disease: a comparison between two data mining algorithms

“…They are sometimes associated with conditions such as hypertension, stroke, coronary artery diseases, chronic heart failure, congenital heart disease, rhythm disorders, subclinical atherosclerosis, valvular disease, and peripheral arterial disease [5]. In recent years, in addition to the main risk factors, other factors such as infection, inflammatory and chronic diseases have been discussed as other risk factors of cardiovascular diseases [6].…”