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The Association between Antibiotic Use and the Incidence of Heart Failure: A Retrospective Case-Control Study of 162,188 Outpatients

The pathogenesis of heart failure (HF) is multifactorial, and is characterized by structural, cellular, and molecular remodeling processes. Inflammatory signaling pathways may play a particularly understudied role in HF. Recent data suggest a possible impact of antibiotic use on HF risk. Therefore,...

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Autores principales: Loosen, Sven H., Krieg, Sarah, Gaensbacher, Julia, Doege, Corinna, Krieg, Andreas, Luedde, Tom, Luedde, Mark, Roderburg, Christoph, Kostev, Karel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9953253/
https://www.ncbi.nlm.nih.gov/pubmed/36830796
http://dx.doi.org/10.3390/biomedicines11020260
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author Loosen, Sven H.
Krieg, Sarah
Gaensbacher, Julia
Doege, Corinna
Krieg, Andreas
Luedde, Tom
Luedde, Mark
Roderburg, Christoph
Kostev, Karel
author_facet Loosen, Sven H.
Krieg, Sarah
Gaensbacher, Julia
Doege, Corinna
Krieg, Andreas
Luedde, Tom
Luedde, Mark
Roderburg, Christoph
Kostev, Karel
author_sort Loosen, Sven H.
collection PubMed
description The pathogenesis of heart failure (HF) is multifactorial, and is characterized by structural, cellular, and molecular remodeling processes. Inflammatory signaling pathways may play a particularly understudied role in HF. Recent data suggest a possible impact of antibiotic use on HF risk. Therefore, the aim of this retrospective case-control study was to investigate the association between antibiotic use and the incidence of HF. Data from the Disease Analyzer (IQVIA) database for patients diagnosed with HF and matched non-HF controls from 983 general practices in Germany between 2000 and 2019 were analyzed. A multivariable conditional logistic regression model was performed. Regression models were calculated for all patients, as well as for data stratified for sex and four age groups. A total of 81,094 patients with HF and 81,094 patients without HF were included in the analyses. In the regression analysis, low, but not high, total antibiotic use was significantly associated with a slightly lower HF risk compared with non-antibiotic users (OR: 0.87; 95% CI: 0.85–0.90). A significantly lower HF incidence was observed for sulfonamides and trimethoprim (OR: 0.87, 95% CI: 0.81–0.93) and for macrolides (OR: 0.87, 95% CI: 0.84–0.91). High use of cephalosporins, however, was associated with an increased HF risk (OR: 1.16; 95% CI: 1.11–1.22). In conclusion, this study from a large real-world cohort from Germany provides evidence that the use of different antibiotics may be associated with HF risk in a dose-dependent manner, possibly due to involved inflammatory processes. Overall, this study should provide a basis for future research to offer new therapeutic strategies for HF patients to improve their limited prognosis.
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spelling pubmed-99532532023-02-25 The Association between Antibiotic Use and the Incidence of Heart Failure: A Retrospective Case-Control Study of 162,188 Outpatients Loosen, Sven H. Krieg, Sarah Gaensbacher, Julia Doege, Corinna Krieg, Andreas Luedde, Tom Luedde, Mark Roderburg, Christoph Kostev, Karel Biomedicines Article The pathogenesis of heart failure (HF) is multifactorial, and is characterized by structural, cellular, and molecular remodeling processes. Inflammatory signaling pathways may play a particularly understudied role in HF. Recent data suggest a possible impact of antibiotic use on HF risk. Therefore, the aim of this retrospective case-control study was to investigate the association between antibiotic use and the incidence of HF. Data from the Disease Analyzer (IQVIA) database for patients diagnosed with HF and matched non-HF controls from 983 general practices in Germany between 2000 and 2019 were analyzed. A multivariable conditional logistic regression model was performed. Regression models were calculated for all patients, as well as for data stratified for sex and four age groups. A total of 81,094 patients with HF and 81,094 patients without HF were included in the analyses. In the regression analysis, low, but not high, total antibiotic use was significantly associated with a slightly lower HF risk compared with non-antibiotic users (OR: 0.87; 95% CI: 0.85–0.90). A significantly lower HF incidence was observed for sulfonamides and trimethoprim (OR: 0.87, 95% CI: 0.81–0.93) and for macrolides (OR: 0.87, 95% CI: 0.84–0.91). High use of cephalosporins, however, was associated with an increased HF risk (OR: 1.16; 95% CI: 1.11–1.22). In conclusion, this study from a large real-world cohort from Germany provides evidence that the use of different antibiotics may be associated with HF risk in a dose-dependent manner, possibly due to involved inflammatory processes. Overall, this study should provide a basis for future research to offer new therapeutic strategies for HF patients to improve their limited prognosis. MDPI 2023-01-18 /pmc/articles/PMC9953253/ /pubmed/36830796 http://dx.doi.org/10.3390/biomedicines11020260 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Loosen, Sven H.
Krieg, Sarah
Gaensbacher, Julia
Doege, Corinna
Krieg, Andreas
Luedde, Tom
Luedde, Mark
Roderburg, Christoph
Kostev, Karel
The Association between Antibiotic Use and the Incidence of Heart Failure: A Retrospective Case-Control Study of 162,188 Outpatients
title The Association between Antibiotic Use and the Incidence of Heart Failure: A Retrospective Case-Control Study of 162,188 Outpatients
title_full The Association between Antibiotic Use and the Incidence of Heart Failure: A Retrospective Case-Control Study of 162,188 Outpatients
title_fullStr The Association between Antibiotic Use and the Incidence of Heart Failure: A Retrospective Case-Control Study of 162,188 Outpatients
title_full_unstemmed The Association between Antibiotic Use and the Incidence of Heart Failure: A Retrospective Case-Control Study of 162,188 Outpatients
title_short The Association between Antibiotic Use and the Incidence of Heart Failure: A Retrospective Case-Control Study of 162,188 Outpatients
title_sort association between antibiotic use and the incidence of heart failure: a retrospective case-control study of 162,188 outpatients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9953253/
https://www.ncbi.nlm.nih.gov/pubmed/36830796
http://dx.doi.org/10.3390/biomedicines11020260
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