Men with sepsis or pneumonia who are admitted to a hospital have an increased risk of cardiovascular disease for more than 5 years post-infection, including a 6-fold risk within the first year, according to a study in the European Journal of Preventive Cardiology.
The cardiovascular risk is more than 2-fold in the second and third years postinfection, reported Cecilia Burgh, BSC, from the School of Medical Sciences, Örebro University, Sweden, and colleagues.
The study included 236,739 men born between 1952 and 1956 who had extensive physical and psychological examinations at or about 18 years of age. Information on infection and cardiovascular disease diagnoses was obtained from a register that has recorded hospital admissions information since 1964. The men were followed from late adolescence through middle age, a process that was completed in 2010.
The researchers analyzed the associations between a first infection with sepsis or pneumonia that resulted in hospital admission with subsequent cardiovascular disease risk at pre-specified time intervals postinfection. During the follow-up, 46,754 men (19.7%) had a first diagnosis of cardiovascular disease. A total of 9,987 hospital admissions for pneumonia or sepsis occurred among 8,534 men who received these diagnoses.
The study authors found that infection was associated with a 6.33-fold increased risk of cardiovascular disease during the first year postinfection. In the second and third years following an infection, the hazard ratios for cardiovascular disease risk were 2.47 and 2.12, respectively. The risk decreased with time but remained for at least 5 years after the infection by nearly twofold (hazard ratio, 1.87). Similar results were found for coronary heart disease, stroke, and fatal cardiovascular disease.
After examining the relationship between other risk factors such as high blood pressure, overweight, obesity, poorer physical fitness, and household crowding in childhood, the investigators found that infection was associated with the highest magnitude of cardiovascular disease risk in the first 3 years post-infection.
“The temporal pattern of association between infections and cardiovascular disease (initially high and then reducing in magnitude) is suggestive of a causal association,” stated the authors. “Our results indicate that even a single serious infection is associated with a persistent risk of cardiovascular disease particularly in the years immediately following the infection.”
Bergh C, Fall K, Udumyan R, Sjöqvist H, Fröbert O. Scott Montgomery. Severe infections and subsequent delayed cardiovascular disease [published online August 1, 2017]. Eur J Prev Cardiol. doi:10.1177/2047487317724009