| Title: | Temporal associations between severe infection and long-term risk of incident arrhythmias: a population-based cohort study |
| Journal: | BMC Medicine |
| Published: | 4 Aug 2026 |
| DOI: | https://doi.org/10.1186/s12916-026-05098-y |
Publication 21196
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Abstract
BackgroundThe 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.MethodsWe 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.ResultsOver 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.ConclusionSevere 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.</p>
9 Authors
- Hai Deng
- Mei-Ping Lin
- Xin-Yan He
- Min-Jing Huang
- Si-Long Lu
- Jin-Bo Fu
- Jun-Chi Li
- Gregory Y. H. Lip
- Yun-Jiu Cheng
1 Application
| Application ID | Title |
|---|---|
| 121022 | Association between early repolarization and cardiovascular outcomes and metabolic outcomes |
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