SYMPTOMATIC INFECTIONS IN PATIENTS WITH ACUTE HEART FAILURE IN A LARGE TERTIARY CARE CARDIOLOGY HOSPITAL

Objectives: To estimate the rates of symptomatic respiratory, gastrointestinal and urinary infections in patients hospitalized with acute heart failure and to describe the clinical characteristics of these patients. Methodology: A cross sectional study was conducted in a large tertiary care cardiology hospital and patients hospitalized due to non-infective causes of heart failure were invited to participate. Trained research assistants collected data using a semi-structured questionnaire. Patients’ medical records were also reviewed. Results: A total of 335 patients were recruited in the study and of them around two thirds (65.7%, 220/335) had the first-time heart failure and one third (34.5%, 115/335) had recurrent heart failure. Acute myocardial infarction rate was significantly higher in first-time heart failure patients, compared to recurrent heart failure patients (p value <0.001). Among all heart failure cases, 140 (41.8%) had symptoms of respiratory infections, 36 (10.7%) had symptoms of diarrhoea, 32 (9.5%) had symptoms of urinary infection, 77 (23.0%) had influenza like illness and 81 (24.2%) had fever during last 2 weeks. Rates of symptomatic respiratory infection, influenza like illness and fever were consistently higher in first-time heart failure patients, however, only respiratory infection during last week was significantly associated with first-time acute heart failure (OR 1.68, 95% CI, 1.02-2.77). Conclusion: This study showed high rates of respiratory and other symptomatic infections in acute heart failure patients. Like other precipitating factors, infections may trigger acute heart failure directly in elderly people. Elderly people should use influenza vaccines to protect from influenza and influenza like illness.