Influenza activity tied to increase in HF hospitalizations

  • Kytömaa S et al.
  • JAMA Cardiol
  • 27 Mar 2019

  • International Clinical Digest
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Takeaway

  • An increase in population-level influenza activity/influenza-like illness (ILI) is associated with increased hospitalizations for heart failure (HF).

Why this matters

  • ILI presenting in a broad range of patients may increase risk for acute cardiovascular events and related hospitalizations, especially during peak influenza activity.

Key results

  • Unweighted total 3541 and 4321 hospitalizations for MI and HF, respectively.
  • Absolute 5% increase in monthly ILI activity associated with 24% increase in HF hospitalization rates in the same month (incidence rate ratio [IRR], 1.24; 95% CI, 1.11-1.38; P<.001>
  • A 22% and 20% temporally associated increased HF risk was observed during severest influenza seasons 2010-2011 (IRR, 1.22; 95% CI, 1.01-1.49; P=.04) and 2012-2013 (IRR, 1.20; 95% CI, 1.02-1.40; P=.02), respectively.
  • Overall influenza activity was not significantly associated with MI hospitalizations (IRR, 1.02; P=.72).
  • HF hospitalization risk reduction noted with reduced ILI activity (IRR, 0.81; 95% CI, 0.72-0.90/absolute 5% decline in ILI), suggesting that it was 19% higher in months with elevated ILI activity vs baseline.

Study design

  • Population-based surveillance study examining temporal ILI and MI, HF hospitalizations in community-dwelling adults, October 2010-September 2014.
  • Funding: NIH.

Limitations

  • Individual-level ILI, MI/HF hospitalizations unknown.
  • Other infections possibly linked to events.
  • Inconsistent influenza severity data.
  • Nongeneralizable.
  • Sampling bias.

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