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TOPLINE
Severe infections were associated with an increased risk of developing heart failure (HF) in a large midwestern population of adult men and women. Among those with a recent infection-related hospitalization (IRH), current risk prediction equations underestimated the 10-year HF risk by up to 9%.
METHODOLOGY
- Researchers studied a geographically defined population in Olmsted County, Minnesota, to examine the association between IRH and HF and to determine whether recent IRH adds predictive value to the existing HF risk equations.
- The association between IRH and incident HF was assessed in a retrospective cohort of 80,880 adults (mean age, 56.0 years; 53.3% women) without prior HF. Of these, 14,150 experienced a first IRH from 2005 to 2019 and were matched by age and sex to 66,730 comparators without an IRH in the previous 5 years.
- A separate risk prediction cohort of 29,219 adults (age, 30-79 years, excluding those with prior cardiovascular disease) was used to evaluate whether adding IRH history to the Predicting Risk of Cardiovascular Disease EVENTs-Heart Failure (PREVENT-HF) equations improved 10-year HF risk prediction.
TAKEAWAY
- During a median follow-up of 6.2 years, patients with IRH developed HF at a higher rate than those without the condition (incidence rate per 100 person-years, 2.75 vs 1.00; adjusted hazard ratio, 1.85; 95% CI, 1.76-1.94).
- The PREVENT-HF equations accurately predicted the 10-year risk for HF with an area under the receiver operating characteristic curve (AUC) of 0.776 (95% CI, 0.764-0.788).
- The PREVENT-HF equations originally underestimated the observed 10-year risk for HF by 8.9% in men and 9.2% in women with a prior IRH; incorporating IRH into the equation changed the AUC to 0.779, representing a change of 0.003 (95% CI, 0.001-0.004).
IN PRACTICE
“We report that severe infections are associated with increased risk of HF in a large, population-based, healthcare system. In a separate sample, we show that knowledge of recent IRH does not meaningfully improve discrimination but may hold promise to target early interventions to prevent HF as a key risk-enhancing factor,” the authors wrote.
SOURCE
The study was led by Ryan T. Demmer, PhD, Mayo Clinic College of Medicine and Science in Rochester, Minnesota. It was published online on August 20 in the Journal of the American Heart Association.
LIMITATIONS
The researchers could not account for certain key confounders that might influence the relationship between IRH and HF. They relied on diagnostic codes to identify IRH, which may have introduced misclassification. The population predominantly comprised White non-Hispanic individuals, limiting generalizability to more diverse populations.
DISCLOSURES
The study was supported by the National Institute on Aging. Some of the authors declared receiving research support from government funding agencies, research grant funding from multiple pharmaceutical and biotechnology companies, and consultancy fees from multiple medical device and pharmaceutical companies.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
