Leah B Kosyakovsky1,2, Federico Angriman3,4,5, Emma Katz6, Neill K Adhikari3,4,5, Lucas C Godoy1,4,7,8, John C Marshall3, Bruno L Ferreyro3,9, Douglas S Lee7,10, Robert S Rosenson11, Naveed Sattar12, Subodh Verma13, Augustin Toma1,2, Marina Englesakis14, Barry Burstein15, Michael E Farkouh2,15, Margaret Herridge3, Dennis T Ko4,7,16, Damon C Scales3,4,5, Michael E Detsky3,9, Lior Bibas17,18, Patrick R Lawler19,20,21. 1. Peter Munk Cardiac Centre, University Health Network, RFE3-410, 190 Elizabeth St, Toronto, Canada. 2. Department of Medicine, University of Toronto, Toronto, Canada. 3. Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada. 4. Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada. 5. Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, Canada. 6. Department of Medicine, McGill University, Montreal, Canada. 7. ICES, Toronto, Canada. 8. Faculdade de Medicina FMUSP, Instituto do Coracao (InCor), Universidade de Sao Paulo, São Paulo, Brazil. 9. Department of Medicine, Sinai Health System and University Health Network, Toronto, Canada. 10. Ted Rogers Centre for Heart Research, Toronto, Canada. 11. Metabolism and Lipids Unit, Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, USA. 12. Institute for Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, Scotland. 13. Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Toronto, Canada. 14. Library and Information Services, University Health Network, Toronto, Canada. 15. Department of Cardiology, Trillium Health Partners, Mississauga, Canada. 16. Schulich Heart Centre, Sunnybrook Health Sciences Centre, Toronto, Canada. 17. Department of Medicine, Hôpital Pierre-Boucher, Longueuil, Canada. 18. Department of Surgical Intensive Care, Montreal Heart Institute, Montreal, Canada. 19. Peter Munk Cardiac Centre, University Health Network, RFE3-410, 190 Elizabeth St, Toronto, Canada. patrick.lawler@uhn.ca. 20. Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada. patrick.lawler@uhn.ca. 21. Ted Rogers Centre for Heart Research, Toronto, Canada. patrick.lawler@uhn.ca.
Abstract
PURPOSE: We aimed to determine the association between sepsis and long-term cardiovascular events. METHODS: We conducted a systematic review of observational studies evaluating post-sepsis cardiovascular outcomes in adult sepsis survivors. MEDLINE, Embase, and the Cochrane Controlled Trials Register and Database of Systematic Reviews were searched from inception until April 21st, 2021. Two reviewers independently extracted individual study data and evaluated risk of bias. Random-effects models estimated the pooled crude cumulative incidence and adjusted hazard ratios (aHRs) of cardiovascular events compared to either non-septic hospital survivors or population controls. Primary outcomes included myocardial infarction, stroke, and congestive heart failure; outcomes were analysed at maximum reported follow-up (from 30 days to beyond 5 years post-discharge). RESULTS: Of 12,649 screened citations, 27 studies (25 cohort studies, 2 case-crossover studies) were included with a median of 4,289 (IQR 502-68,125) sepsis survivors and 18,399 (IQR 4,028-83,506) controls per study. The pooled cumulative incidence of myocardial infarction, stroke, and heart failure in sepsis survivors ranged from 3 to 9% at longest reported follow-up. Sepsis was associated with a higher long-term risk of myocardial infarction (aHR 1.77 [95% CI 1.26 to 2.48]; low certainty), stroke (aHR 1.67 [95% CI 1.37 to 2.05]; low certainty), and congestive heart failure (aHR 1.65 [95% CI 1.46 to 1.86]; very low certainty) compared to non-sepsis controls. CONCLUSIONS: Surviving sepsis may be associated with a long-term, excess hazard of late cardiovascular events which may persist for at least 5 years following hospital discharge.
PURPOSE: We aimed to determine the association between sepsis and long-term cardiovascular events. METHODS: We conducted a systematic review of observational studies evaluating post-sepsis cardiovascular outcomes in adult sepsis survivors. MEDLINE, Embase, and the Cochrane Controlled Trials Register and Database of Systematic Reviews were searched from inception until April 21st, 2021. Two reviewers independently extracted individual study data and evaluated risk of bias. Random-effects models estimated the pooled crude cumulative incidence and adjusted hazard ratios (aHRs) of cardiovascular events compared to either non-septic hospital survivors or population controls. Primary outcomes included myocardial infarction, stroke, and congestive heart failure; outcomes were analysed at maximum reported follow-up (from 30 days to beyond 5 years post-discharge). RESULTS: Of 12,649 screened citations, 27 studies (25 cohort studies, 2 case-crossover studies) were included with a median of 4,289 (IQR 502-68,125) sepsis survivors and 18,399 (IQR 4,028-83,506) controls per study. The pooled cumulative incidence of myocardial infarction, stroke, and heart failure in sepsis survivors ranged from 3 to 9% at longest reported follow-up. Sepsis was associated with a higher long-term risk of myocardial infarction (aHR 1.77 [95% CI 1.26 to 2.48]; low certainty), stroke (aHR 1.67 [95% CI 1.37 to 2.05]; low certainty), and congestive heart failure (aHR 1.65 [95% CI 1.46 to 1.86]; very low certainty) compared to non-sepsis controls. CONCLUSIONS: Surviving sepsis may be associated with a long-term, excess hazard of late cardiovascular events which may persist for at least 5 years following hospital discharge.
Authors: Nicolas Nesseler; Anne Defontaine; Yoann Launey; Jeff Morcet; Yannick Mallédant; Philippe Seguin Journal: Intensive Care Med Date: 2013-01-29 Impact factor: 17.440
Authors: Mitchell M Levy; Andrew Rhodes; Gary S Phillips; Sean R Townsend; Christa A Schorr; Richard Beale; Tiffany Osborn; Stanley Lemeshow; Jean-Daniel Chiche; Antonio Artigas; R Phillip Dellinger Journal: Crit Care Med Date: 2015-01 Impact factor: 7.598
Authors: Sachin Yende; Gina D'Angelo; Florian Mayr; John A Kellum; Lisa Weissfeld; A Murat Kaynar; Tammy Young; Kaikobad Irani; Derek C Angus Journal: PLoS One Date: 2011-08-10 Impact factor: 3.240
Authors: Tim Rahmel; Stefanie Schmitz; Hartmuth Nowak; Kaspar Schepanek; Lars Bergmann; Peter Halberstadt; Stefan Hörter; Jürgen Peters; Michael Adamzik Journal: PLoS One Date: 2020-02-12 Impact factor: 3.240
Authors: Nazir I Lone; Michael A Gillies; Catriona Haddow; Richard Dobbie; Kathryn M Rowan; Sarah H Wild; Gordon D Murray; Timothy S Walsh Journal: Am J Respir Crit Care Med Date: 2016-07-15 Impact factor: 21.405
Authors: Brian H Cuthbertson; Andrew Elders; Sally Hall; Jane Taylor; Graeme MacLennan; Fiona Mackirdy; Simon J Mackenzie Journal: Crit Care Date: 2013-04-16 Impact factor: 9.097
Authors: Kristina E Rudd; Sarah Charlotte Johnson; Kareha M Agesa; Katya Anne Shackelford; Derrick Tsoi; Daniel Rhodes Kievlan; Danny V Colombara; Kevin S Ikuta; Niranjan Kissoon; Simon Finfer; Carolin Fleischmann-Struzek; Flavia R Machado; Konrad K Reinhart; Kathryn Rowan; Christopher W Seymour; R Scott Watson; T Eoin West; Fatima Marinho; Simon I Hay; Rafael Lozano; Alan D Lopez; Derek C Angus; Christopher J L Murray; Mohsen Naghavi Journal: Lancet Date: 2020-01-18 Impact factor: 202.731
Authors: Zachary Mostel; Abraham Perl; Matthew Marck; Syed F Mehdi; Barbara Lowell; Sagar Bathija; Ramchandani Santosh; Valentin A Pavlov; Sangeeta S Chavan; Jesse Roth Journal: Mol Med Date: 2019-12-31 Impact factor: 6.354
Authors: Federico Angriman; Laura C Rosella; Patrick R Lawler; Dennis T Ko; Hannah Wunsch; Damon C Scales Journal: Intensive Care Med Date: 2022-02-10 Impact factor: 41.787
Authors: Nicholas Felici; Da Liu; Josh Maret; Mariana Restrepo; Yuliya Borovskiy; Jihane Hajj; Wesley Chung; Krzysztof Laudanski Journal: Front Cardiovasc Med Date: 2021-11-15