Abstract Background Septic shock is a life-threatening condition that can lead to multiorgan failure including cardiac dysfunction. Data remain limited on whether survivors of septic shock face a higher long-term risk of cardiovascular disease. Purpose To assess the long-term risk of heart failure, arrhythmia, and acute coronary syndrome in patients who have survived septic shock without a prior history of these conditions. Methods Using Danish nationwide registers, we identified all patients diagnosed with septic shock, defined by a hospital diagnosis code for septic shock or sepsis along with the use of vasopressors or inotropic agents. Patients who died during hospitalization or had a history of heart failure, arrhythmia, or acute coronary syndrome were excluded. Survivors were followed for up to five years, as we estimated the 5-year standardized absolute risk (SAR) of heart failure, arrhythmia, and acute coronary syndrome individually, as well as a composite outcome. For all outcomes, death was considered as competing risk. Finally, 5-year standardized risk ratios (SRR) were computed. For comparison, we identified patients with simple infections (urinary tract infections or erysipelas) or sepsis and estimated the risk of these cardiovascular outcomes within these groups. Results We identified 6,050 patients with septic shock (47% female, median age 67 years), 65,270 patients with simple infections (64% female, median age 70 years), and 32,687 patients with sepsis (45% female, median age 69 years). At 5.0% (95% CI 4.3%-5.7%), the 5-year SAR of heart failure was highest in the septic shock group, compared with 3.9% (95% CI 3.6%-4.1%) in the simple infection group (Figure 1). Using the simple infection group as a reference, this corresponded to a 5-year SRR of 1.3 (95% CI 1.1-1.5) (Figure 2). When compared with simple infections, the 5-year SAR of arrhythmia was higher for patients with septic shock at 10.1% (95% CI 9.1%-11.0%), while for acute coronary syndrome, it was similar at 1.7% (95% CI 1.3%-2.1%). Considering a composite outcome of heart failure, arrhythmia, and acute coronary syndrome, the 5-year SAR was 14.2% (95% CI 13.1%-15.3%) with a corresponding 5-year SRR of 1.1 (95% CI 1.0-1.2). Conclusions Survivors of septic shock face a significantly increased long-term risk of heart failure and clinically relevant arrhythmia, despite high overall mortality rates. These findings underscore the need for heightened awareness of cardiovascular symptoms in this patient population to enable early diagnosis and intervention, potentially improving long-term outcomes.
Strange et al. (Sat,) studied this question.