• Jiazhen Zheng, Can Ni, S W Ricky Lee, Fu-Rong Li, Jinghan Huang, Rui Zhou, Yining Huang, LipGregory Y HGYHLiverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool John Moores University, Liverpool Heart and Chest Hospital, Liverpool, UK.Department of Clinical Medicine, Danish Center for Clinical Health Services Research, Xianbo Wu, and Shaojun Tang.
• Bioscience and Biomedical Engineering Thrust, Systems Hub, The Hong Kong University of Science and Technology (Guangzhou), Guangzhou, Guangdong, China.
• J. Intern. Med. 2024 May 1; 295 (5): 679694679-694.

BackgroundThe association of a broad spectrum of infectious diseases with cardiovascular outcomes remains unclear.ObjectivesWe aim to provide the cardiovascular risk profiles associated with a wide range of infectious diseases and explore the extent to which infections reduce life expectancy.MethodsWe ascertained exposure to 900+ infectious diseases before cardiovascular disease (CVD) onset in 453,102 participants from the UK Biobank study. Time-varying Cox proportional hazard models were used. Life table was used to estimate the life expectancy of individuals aged ≥50 with different levels of infection burden (defined as the number of infection episodes over time and the number of co-occurring infections).ResultsInfectious diseases were associated with a greater risk of CVD events (adjusted HR [aHR] 1.79 [95% confidence interval {CI} 1.74-1.83]). For type-specific analysis, bacterial infection with sepsis had the strongest risk of CVD events [aHR 4.76 (4.35-5.20)]. For site-specific analysis, heart and circulation infections posed the greatest risk of CVD events [aHR 4.95 (95% CI 3.77-6.50)], whereas noncardiac infections also showed excess risk [1.77 (1.72-1.81)]. Synergistic interactions were observed between infections and genetic risk score. A dose-response relationship was found between infection burden and CVD risks (p-trend <0.001). Infection burden >1 led to a CVD-related life loss at age 50 by 9.3 years [95% CI 8.6-10.3]) for men and 6.6 years [5.5-7.8] for women.ConclusionsThe magnitude of the infection-CVD association showed specificity in sex, pathogen type, infection burden, and infection site. High genetic risk and infection synergistically increased the CVD risk.© 2024 The Association for the Publication of the Journal of Internal Medicine.

14 keywords...

hide…