Article Impact Level: HIGH Data Quality: STRONG Summary of Journal of the American Heart Association, e033877. https://doi.org/10.1161/JAHA.123.033877 Dr. Rebecca L. Molinsky et al.
Points
- Individuals with infection-related hospitalizations (IRH) had a 2.35 times higher risk of developing HF compared to those without IRH.
- IRH was linked to both heart failure with reduced ejection fraction (HFrEF) (HR: 1.77) and heart failure with preserved ejection fraction (HFpEF) (HR: 2.97), with a stronger association for HFpEF.
- The relationship between IRH and HF was observed regardless of the type of infection, indicating a broad impact on cardiac health.
- The study suggests that preventing and managing infections could reduce the risk of HF, emphasizing the role of infection control in cardiovascular health.
- With a 27-year follow-up, these findings support integrating infection prevention strategies into HF risk management to mitigate disease progression.
Summary
This study examined the association between infection-related hospitalizations (IRH) and the development of heart failure (HF), including both HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF). Data were drawn from 14,468 adults aged 45 to 64 in the Atherosclerosis Risk in Communities (ARIC) Study, all free from HF at baseline (1987–1989). IRH was identified using ICD codes from hospital discharge records and treated as a time-varying exposure. The study found that IRH was significantly associated with an increased risk of developing HF, with a hazard ratio (HR) for incident HF of 2.35 (95% CI, 2.19–2.52) in individuals who experienced an IRH compared to those who did not.
The analysis revealed that the relationship between IRH and incident HF was consistent across various infections. Specifically, IRH was linked to both HFrEF and HFpEF. For HFrEF, the HR was 1.77 (95% CI, 1.35–2.32), while for HFpEF, the HR was 2.97 (95% CI, 2.36–3.75). These findings suggest that infection-related hospitalizations might contribute to the pathophysiology of HFrEF and HFpEF, with a stronger association seen in HFpEF.
The study’s conclusions highlight IRH as a potentially modifiable risk factor for the development of HF. Given the long-term follow-up period of 27 years, these results underscore the importance of addressing infection-related factors in preventing and managing heart failure. The findings suggest that reducing IRH could help mitigate the risk of developing HFrEF and HFpEF, thus potentially informing clinical strategies to prevent heart failure progression.
Link to the article: https://www.ahajournals.org/doi/10.1161/JAHA.123.033877
References Molinsky, R. L., Shah, A., Yuzefpolskaya, M., Yu, B., Misialek, J. R., Bohn, B., Vock, D., MacLehose, R., Borlaug, B. A., Colombo, P. C., Ndumele, C. E., Ishigami, J., Matsushita, K., Lutsey, P. L., & Demmer, R. T. (2025). Infection‐related hospitalization and incident heart failure: The atherosclerosis risk in communities study. Journal of the American Heart Association, e033877. https://doi.org/10.1161/JAHA.123.033877
