Infection‐Related Hospitalization and Incident Heart Failure: The Atherosclerosis Risk in Communities Study
Background The immune response to infections may become dysregulated and promote myocardial damage contributing to heart failure (HF). We examined the relationship between infection‐related hospitalization (IRH) and HF, HF with preserved ejection fraction, and HF with reduced ejection fraction. Meth...
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Wiley
2025-02-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
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| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.123.033877 |
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| author | Rebecca L. Molinsky Amil Shah Melana Yuzefpolskaya Bing Yu Jeffrey R. Misialek Bruno Bohn David Vock Richard MacLehose Barry A. Borlaug Paolo C. Colombo Chiadi E. Ndumele Junichi Ishigami Kunihiro Matsushita Pamela L. Lutsey Ryan T. Demmer |
| author_facet | Rebecca L. Molinsky Amil Shah Melana Yuzefpolskaya Bing Yu Jeffrey R. Misialek Bruno Bohn David Vock Richard MacLehose Barry A. Borlaug Paolo C. Colombo Chiadi E. Ndumele Junichi Ishigami Kunihiro Matsushita Pamela L. Lutsey Ryan T. Demmer |
| author_sort | Rebecca L. Molinsky |
| collection | DOAJ |
| description | Background The immune response to infections may become dysregulated and promote myocardial damage contributing to heart failure (HF). We examined the relationship between infection‐related hospitalization (IRH) and HF, HF with preserved ejection fraction, and HF with reduced ejection fraction. Methods and Results We studied 14 468 adults aged 45 to 64 years in the ARIC (Atherosclerosis Risk in Communities) Study who were HF free at visit 1 (1987–1989). IRH was identified using select International Classification of Diseases (ICD) codes in hospital discharge records and was treated as a time‐varying exposure. HF incidence was defined as the first occurrence of either a hospitalization that included an ICD, Ninth Revision (ICD‐9) discharge code of 428 (428.0–428.9) among the primary or secondary diagnoses or a death certificate with an ICD‐9 code of 428 or an ICD, Tenth Revision (ICD‐10) code of I50 among any of the listed diagnoses or underlying causes of death. We used multivariable‐adjusted Cox proportional hazards models to assess the association between IRH and incident HF, HF with reduced ejection fraction, and HF with preserved ejection fraction. Median follow‐up time was 27 years, 55% were women, 26% were Black, mean age at baseline was 54±6 years, 46% had an IRH, and 3565 had incident HF. Hazard ratio (HR) for incident HF events among participants who had an IRH compared with those who did not was 2.35 (95% CI, 2.19–2.52). This relationship was consistent across different types of infections. Additionally, IRH was associated with both HF with reduced ejection fraction and HF with preserved ejection fraction: 1.77 (95% CI, 1.35–2.32) and 2.97 (95% CI, 2.36–3.75), respectively. Conclusions IRH was associated with incident HF, HF with reduced ejection fraction, and HF with preserved ejection fraction. IRH might represent a modifiable risk factor for HF pathophysiology. |
| format | Article |
| id | doaj-art-e21a888aca6549e69b837dabbbd7cd90 |
| institution | Kabale University |
| issn | 2047-9980 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-e21a888aca6549e69b837dabbbd7cd902025-02-04T11:00:01ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802025-02-0114310.1161/JAHA.123.033877Infection‐Related Hospitalization and Incident Heart Failure: The Atherosclerosis Risk in Communities StudyRebecca L. Molinsky0Amil Shah1Melana Yuzefpolskaya2Bing Yu3Jeffrey R. Misialek4Bruno Bohn5David Vock6Richard MacLehose7Barry A. Borlaug8Paolo C. Colombo9Chiadi E. Ndumele10Junichi Ishigami11Kunihiro Matsushita12Pamela L. Lutsey13Ryan T. Demmer14Division of Epidemiology and Community Health, School of Public Health University of Minnesota Minneapolis MN USACardiovascular Imaging Program, Departments of Medicine and Radiology Brigham and Women’s Hospital, Harvard Medical School Boston MA USADivision of Cardiology, Department of Medicine Columbia University Irving Medical Center New York NY USADepartment of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health University of Texas Health Science Center at Houston Houston TX USADivision of Epidemiology and Community Health, School of Public Health University of Minnesota Minneapolis MN USADivision of Epidemiology and Community Health, School of Public Health University of Minnesota Minneapolis MN USADivision of Biostatistics, School of Public Health University of Minnesota Minneapolis MN USADivision of Epidemiology and Community Health, School of Public Health University of Minnesota Minneapolis MN USADepartment of Cardiovascular Medicine Mayo Clinic College of Medicine and Science Rochester MN USADivision of Cardiology, Department of Medicine Columbia University Irving Medical Center New York NY USAJohns Hopkins Ciccarone Center for the Prevention of Heart Disease Johns Hopkins University School of Medicine Baltimore MD USADepartment of Epidemiology, Bloomberg School of Public Health Johns Hopkins University Baltimore MD USADepartment of Epidemiology, Bloomberg School of Public Health Johns Hopkins University Baltimore MD USADivision of Epidemiology and Community Health, School of Public Health University of Minnesota Minneapolis MN USADivision of Epidemiology and Community Health, School of Public Health University of Minnesota Minneapolis MN USABackground The immune response to infections may become dysregulated and promote myocardial damage contributing to heart failure (HF). We examined the relationship between infection‐related hospitalization (IRH) and HF, HF with preserved ejection fraction, and HF with reduced ejection fraction. Methods and Results We studied 14 468 adults aged 45 to 64 years in the ARIC (Atherosclerosis Risk in Communities) Study who were HF free at visit 1 (1987–1989). IRH was identified using select International Classification of Diseases (ICD) codes in hospital discharge records and was treated as a time‐varying exposure. HF incidence was defined as the first occurrence of either a hospitalization that included an ICD, Ninth Revision (ICD‐9) discharge code of 428 (428.0–428.9) among the primary or secondary diagnoses or a death certificate with an ICD‐9 code of 428 or an ICD, Tenth Revision (ICD‐10) code of I50 among any of the listed diagnoses or underlying causes of death. We used multivariable‐adjusted Cox proportional hazards models to assess the association between IRH and incident HF, HF with reduced ejection fraction, and HF with preserved ejection fraction. Median follow‐up time was 27 years, 55% were women, 26% were Black, mean age at baseline was 54±6 years, 46% had an IRH, and 3565 had incident HF. Hazard ratio (HR) for incident HF events among participants who had an IRH compared with those who did not was 2.35 (95% CI, 2.19–2.52). This relationship was consistent across different types of infections. Additionally, IRH was associated with both HF with reduced ejection fraction and HF with preserved ejection fraction: 1.77 (95% CI, 1.35–2.32) and 2.97 (95% CI, 2.36–3.75), respectively. Conclusions IRH was associated with incident HF, HF with reduced ejection fraction, and HF with preserved ejection fraction. IRH might represent a modifiable risk factor for HF pathophysiology.https://www.ahajournals.org/doi/10.1161/JAHA.123.033877epidemiologyheart failureinfections |
| spellingShingle | Rebecca L. Molinsky Amil Shah Melana Yuzefpolskaya Bing Yu Jeffrey R. Misialek Bruno Bohn David Vock Richard MacLehose Barry A. Borlaug Paolo C. Colombo Chiadi E. Ndumele Junichi Ishigami Kunihiro Matsushita Pamela L. Lutsey Ryan T. Demmer Infection‐Related Hospitalization and Incident Heart Failure: The Atherosclerosis Risk in Communities Study Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease epidemiology heart failure infections |
| title | Infection‐Related Hospitalization and Incident Heart Failure: The Atherosclerosis Risk in Communities Study |
| title_full | Infection‐Related Hospitalization and Incident Heart Failure: The Atherosclerosis Risk in Communities Study |
| title_fullStr | Infection‐Related Hospitalization and Incident Heart Failure: The Atherosclerosis Risk in Communities Study |
| title_full_unstemmed | Infection‐Related Hospitalization and Incident Heart Failure: The Atherosclerosis Risk in Communities Study |
| title_short | Infection‐Related Hospitalization and Incident Heart Failure: The Atherosclerosis Risk in Communities Study |
| title_sort | infection related hospitalization and incident heart failure the atherosclerosis risk in communities study |
| topic | epidemiology heart failure infections |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.123.033877 |
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