TY - JOUR T1 - Intermediate and long-term risk of new-onset heart failure after hospitalization for pneumonia in elderly adults. JF - Am Heart J Y1 - 2015 A1 - Corrales-Medina, Vicente F A1 - Taljaard, Monica A1 - Yende, Sachin A1 - Kronmal, Richard A1 - Dwivedi, Girish A1 - Newman, Anne B A1 - Elkind, Mitchell S V A1 - Lyles, Mary F A1 - Chirinos, Julio A KW - Aged KW - Disease Progression KW - Female KW - Follow-Up Studies KW - Forecasting KW - Heart Failure KW - Hospitalization KW - Humans KW - Incidence KW - Inpatients KW - Male KW - Patient Readmission KW - Pneumonia KW - Proportional Hazards Models KW - Retrospective Studies KW - Risk Assessment KW - Risk Factors KW - Time Factors AB -

BACKGROUND: Pneumonia is associated with high risk of heart failure (HF) in the short term (30 days) postinfection. Whether this association persists beyond this period is unknown.

METHODS: We studied 5,613 elderly (≥65 years) adults enrolled in the Cardiovascular Health Study between 1989 and 1994 at 4 US communities. Participants had no clinical diagnosis of HF at enrollment, and they were followed up through December 2010. Hospitalizations for pneumonia were identified using validated International Classification of Disease Ninth Revision codes. A centralized committee adjudicated new-onset HF events. Using Cox regression, we estimated adjusted hazard ratios (HRs) of new-onset HF at different time intervals after hospitalization for pneumonia.

RESULTS: A total of 652 participants hospitalized for pneumonia during follow-up were still alive and free of clinical diagnosis of HF by day 30 posthospitalization. Relative to the time of their hospitalization, new-onset HF occurred in 22 cases between 31 and 90 days (HR 6.9, 95% CI 4.46-10.63, P < .001), 14 cases between 91 days and 6 months (HR 3.2, 95% CI 1.88-5.50, P < .001), 20 cases between 6 months and 1 year (HR 2.6, 95% CI 1.64-4.04, P < .001), 76 cases between 1 and 5 years (HR 1.7, 95% CI 1.30-2.12, P < .001), and 71 cases after 5 years (HR 2.0, 95% CI 1.56-2.58, P < .001). Results were robust to sensitivity analyses using stringent definitions of pneumonia and extreme assumptions for potential informative censoring.

CONCLUSION: Hospitalization for pneumonia is associated with increased risk of new-onset HF in the intermediate and long term. Studies should characterize the mechanisms of this association in order to prevent HF in elderly pneumonia survivors.

VL - 170 IS - 2 U1 - http://www.ncbi.nlm.nih.gov/pubmed/26299228?dopt=Abstract ER -