Heart failure associated with imported malaria: A nationwide Danish cohort study
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Heart failure associated with imported malaria : A nationwide Danish cohort study. / Brainin, Philip; Mohr, Grimur Hognason; Modin, Daniel; Claggett, Brian; Silvestre, Odilson M.; Shah, Amil; Vestergaard, Lasse S.; Jensen, Jens Ulrik Staehr; Hviid, Lars; Torp-Pedersen, Christian; Kober, Lars; Solomon, Scott; Schou, Morten; Gislason, Gunnar H.; Biering-Sorensen, Tor.
In: ESC heart failure, Vol. 8, No. 5, 2021, p. 3521-3529.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Heart failure associated with imported malaria
T2 - A nationwide Danish cohort study
AU - Brainin, Philip
AU - Mohr, Grimur Hognason
AU - Modin, Daniel
AU - Claggett, Brian
AU - Silvestre, Odilson M.
AU - Shah, Amil
AU - Vestergaard, Lasse S.
AU - Jensen, Jens Ulrik Staehr
AU - Hviid, Lars
AU - Torp-Pedersen, Christian
AU - Kober, Lars
AU - Solomon, Scott
AU - Schou, Morten
AU - Gislason, Gunnar H.
AU - Biering-Sorensen, Tor
PY - 2021
Y1 - 2021
N2 - Aims Despite adequate treatment, recent studies have hypothesized that malaria may affect long-term cardiovascular function. We aimed to investigate the long-term risk of cardiovascular events and death in individuals with a history of imported malaria in Denmark.Methods Using nationwide Danish registries, we followed individuals with a history of malaria for the risk of incident heart failure (HF), myocardial infarction (MI), cardiovascular death and all-cause death (1 January 1994 to 1 January 2017). The population was age- and sex-matched with individuals without a history of malaria from the Danish population (ratio 1:9). We excluded patients with known HF and ischaemic heart disease at inclusion.Results We identified 3912 cases with a history of malaria (mean age 33 +/- 17 years, 57% male, 41% Plasmodium falciparum infections). The median follow-up was 9.8 years (interquartile range 3.9-16.4 years). Event rates per 1000 person-years for individuals with a history vs. no history of malaria were HF: 1.84 vs. 1.32; MI: 1.28 vs. 1.30; cardiovascular death: 1.40 vs. 1.77; and all-cause death: 5.04 vs. 5.28. In Cox proportional hazards models adjusted for cardiovascular risk factors, concomitant pharmacotherapy, region of origin, household income and educational level, malaria was associated with HF (HR: 1.59 [1.21-2.09], P = 0.001), but not MI (HR: 1.00 [0.72-1.39], P = 1.00), cardiovascular death (HR: 1.00 [0.74-1.35], P = 0.98) or all-cause death (HR 1.11 [0.94-1.30], P = 0.21). Specifically, P. falciparum infection was associated with increased risk of HF (HR: 1.64 [1.14-2.36], P = 0.008).Conclusion Individuals with a history of imported malaria, specifically P. falciparum, may have an increased risk of incident HF.
AB - Aims Despite adequate treatment, recent studies have hypothesized that malaria may affect long-term cardiovascular function. We aimed to investigate the long-term risk of cardiovascular events and death in individuals with a history of imported malaria in Denmark.Methods Using nationwide Danish registries, we followed individuals with a history of malaria for the risk of incident heart failure (HF), myocardial infarction (MI), cardiovascular death and all-cause death (1 January 1994 to 1 January 2017). The population was age- and sex-matched with individuals without a history of malaria from the Danish population (ratio 1:9). We excluded patients with known HF and ischaemic heart disease at inclusion.Results We identified 3912 cases with a history of malaria (mean age 33 +/- 17 years, 57% male, 41% Plasmodium falciparum infections). The median follow-up was 9.8 years (interquartile range 3.9-16.4 years). Event rates per 1000 person-years for individuals with a history vs. no history of malaria were HF: 1.84 vs. 1.32; MI: 1.28 vs. 1.30; cardiovascular death: 1.40 vs. 1.77; and all-cause death: 5.04 vs. 5.28. In Cox proportional hazards models adjusted for cardiovascular risk factors, concomitant pharmacotherapy, region of origin, household income and educational level, malaria was associated with HF (HR: 1.59 [1.21-2.09], P = 0.001), but not MI (HR: 1.00 [0.72-1.39], P = 1.00), cardiovascular death (HR: 1.00 [0.74-1.35], P = 0.98) or all-cause death (HR 1.11 [0.94-1.30], P = 0.21). Specifically, P. falciparum infection was associated with increased risk of HF (HR: 1.64 [1.14-2.36], P = 0.008).Conclusion Individuals with a history of imported malaria, specifically P. falciparum, may have an increased risk of incident HF.
KW - Malaria
KW - Heart failure
KW - Prognosis
KW - Infectious diseases
KW - Epidemiology
KW - CARDIOVASCULAR INVOLVEMENT
KW - VIVAX
U2 - 10.1002/ehf2.13441
DO - 10.1002/ehf2.13441
M3 - Journal article
C2 - 34313024
VL - 8
SP - 3521
EP - 3529
JO - E S C Heart Failure
JF - E S C Heart Failure
SN - 2055-5822
IS - 5
ER -
ID: 275528911