Temporal associations between severe infection and long-term risk of incident arrhythmias: a population-based cohort study.
7 affiliations
- 1Department of Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China. [email protected].
- 2Department of Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.
- 3School of Medicine, South China University of Technology, Guangzhou, China.
- 4Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom. [email protected].
- 5Department of Clinical Medicine, Aalborg University, Aalborg, Denmark. [email protected].
- 6Department of Cardiology, Lipidology and Internal Medicine with Intensive Coronary Care Unit, Medical University of Bialystok, Bialystok, Poland. [email protected].
- 7Department of Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China. [email protected].
Abstract
Background
The long-term impact of severe infection on arrhythmia risk across the cardiac rhythm spectrum remains incompletely characterized. We investigated the association between hospital-treated infection and incident arrhythmias, examining temporal patterns, pathogen and site specificity, and cumulative effects.Methods
We conducted a prospective analysis of 465,374 UK Biobank participants. Time-dependent Cox proportional hazards models were adjusted for sociodemographic factors, lifestyle behaviors, clinical comorbidities, and biochemical parameters. Comprehensive analyses assessed infection timing (1-30, 31-365, ≥366 days), type (bacterial, viral, sepsis), site, and recurrence. Findings were validated in ARIC and CHS cohorts.Results
Over a median follow-up of 14.2 years, 70,527 (15.2%) participants had a severe infection. Infection was associated with a significantly increased risk of any incident arrhythmia (adjusted HR 1.85, 95% CI 1.80-1.90). Risks were elevated across all specific arrhythmias, being particularly pronounced for sudden cardiac arrest (HR 2.79, 2.54-3.07), ventricular arrhythmias (HR 3.11, 2.80-3.45), and AV block (HR 3.03, 2.83-3.25). Risk demonstrated temporal gradient, peaking at 1-30 days (HR 11.40, 10.44-12.47 for any arrhythmia) and remaining elevated long-term (HR 1.58, 1.53-1.63 at ≥366 days). Sepsis posed the highest risk among infection types, while pneumonia was most hazardous among sites. Recurrent infections showed a dose-response relationship, with second infections conferring greater risk than first infections (HR 2.51 vs 1.85). Population attributable fractions for infection reached 16.6% for AV block, comparable to traditional risk factors. External validation confirmed these associations.Conclusion
Severe infection is associated with increased long-term risks of various arrhythmias, with variations by time since infection, infection characteristics, and recurrence history. These observations suggest that a history of severe infection may provide modest additional information for arrhythmia risk assessment, though its contribution is substantially smaller than that of traditional risk factors such as hypertension.
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BibTeX
@article{deng2026temporal,
title = {{Temporal associations between severe infection and long-term risk of incident arrhythmias: a population-based cohort study.}},
author = {Hai Deng and Mei-Ping Lin and Xin-Yan He and Min-Jing Huang and Si-Long Lu and Jin-Bo Fu and Jun-Chi Li and Gregory Y H Lip and Yun-Jiu Cheng},
journal = {BMC medicine},
year = {2026},
month = aug,
doi = {10.1186/s12916-026-05098-y},
url = {https://europepmc.org/article/MED/42972595},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Temporal associations between severe infection and long-term risk of incident arrhythmias: a population-based cohort study.
AU - Hai Deng
AU - Mei-Ping Lin
AU - Xin-Yan He
AU - Min-Jing Huang
AU - Si-Long Lu
AU - Jin-Bo Fu
AU - Jun-Chi Li
AU - Gregory Y H Lip
AU - Yun-Jiu Cheng
PY - 2026
DA - 2026/08/04
JO - BMC medicine
DO - 10.1186/s12916-026-05098-y
UR - https://europepmc.org/article/MED/42972595
AB - Background The long-term impact of severe infection on arrhythmia risk across the cardiac rhythm spectrum remains incompletely characterized. We investigated the association between hospital-treated infection and incident arrhythmias, examining temporal patterns, pathogen and site specificity, and cumulative effects.Methods We conducted a prospective analysis of 465,374 UK Biobank participants. Time-dependent Cox proportional hazards models were adjusted for sociodemographic factors, lifestyle behaviors, clinical comorbidities, and biochemical parameters. Comprehensive analyses assessed infection timing (1-30, 31-365, ≥366 days), type (bacterial, viral, sepsis), site, and recurrence. Findings were validated in ARIC and CHS cohorts.Results Over a median follow-up of 14.2 years, 70,527 (15.2%) participants had a severe infection. Infection was associated with a significantly increased risk of any incident arrhythmia (adjusted HR 1.85, 95% CI 1.80-1.90). Risks were elevated across all specific arrhythmias, being particularly pronounced for sudden cardiac arrest (HR 2.79, 2.54-3.07), ventricular arrhythmias (HR 3.11, 2.80-3.45), and AV block (HR 3.03, 2.83-3.25). Risk demonstrated temporal gradient, peaking at 1-30 days (HR 11.40, 10.44-12.47 for any arrhythmia) and remaining elevated long-term (HR 1.58, 1.53-1.63 at ≥366 days). Sepsis posed the highest risk among infection types, while pneumonia was most hazardous among sites. Recurrent infections showed a dose-response relationship, with second infections conferring greater risk than first infections (HR 2.51 vs 1.85). Population attributable fractions for infection reached 16.6% for AV block, comparable to traditional risk factors. External validation confirmed these associations.Conclusion Severe infection is associated with increased long-term risks of various arrhythmias, with variations by time since infection, infection characteristics, and recurrence history. These observations suggest that a history of severe infection may provide modest additional information for arrhythmia risk assessment, though its contribution is substantially smaller than that of traditional risk factors such as hypertension.
SN - 1741-7015
ER -