More than one in five older adults hospitalized with respiratory syncytial virus (RSV) infection experience acute heart disease, an observational study has found.

Of the 6,248 hospitalized patients age 50 and older with laboratory-confirmed RSV infection, 22% experienced acute heart disease, most commonly acute heart failure (16%), said Dr. Rebecca Woodruff of the CDC’s Division of Cardiology. , researchers led by MPH reported. Stroke Prevention in Chamblee, Georgia.

Patients who experienced an acute cardiac event had a significant risk of ICU admission (25.8% vs 16.5%, ARR 1.54, 95% CI 1.23-1.93) and in-hospital death (8.1% vs 4.0%, ARR 1.77, 95% CI 1.36) It was expensive. -2.31), research in JAMA Internal Medicine showed that.

“The results of this study suggest that acute cardiac events are common in older adults hospitalized with RSV infection and are associated with severe clinical outcomes,” Woodruff et al. The study also supports previous findings that acute heart failure, coronary events, and atrial fibrillation occur more frequently among adults hospitalized with acute respiratory infections such as influenza and SARS-CoV-2. The researchers added that

The prevalence of acute cardiac events was highest in patients with underlying cardiovascular disease (33%). However, acute heart disease also occurred in 8.5% of patients without underlying heart disease, demonstrating that severe RSV infection can exacerbate or reveal undiagnosed cardiovascular disease. suggestive, Woodruff’s team said.

“Another novel finding from this study is the infrequent but life-threatening conditions that can occur in association with RSV infection, including ventricular tachycardia, hypertensive crisis, cardiogenic shock, and acute myocarditis. “We identified the phenomenon,” the researchers wrote.

The findings are particularly relevant given that the first two RSV vaccines for adults 60 and older, recommended for use with shared decision-making, were approved by the FDA in 2023, the study authors said. pointed out. Additional vaccine candidates are in clinical trials, and indications may be expanded to adults aged 50 to 59. The study suggests that potentially vaccine-preventable diseases may represent a significant burden, the researchers said.

Tracy Wang, M.D., of the Patient-Centered Outcomes Research Institute in Washington, D.C., and associate editor of the journal, said uptake of the new RSV vaccine is low, especially compared to the influenza vaccine. JAMA Internal Medicinein an accompanying editorial.

“Previous RSV-related efforts have focused on infants and young children, and many clinicians and patients are still unaware of the disease and prognosis associated with RSV in older adults,” Wang wrote. , added that older adults are particularly vulnerable as they have more cardiopulmonary comorbidities. Decreased functional reserve.

During last year’s surge in RSV infections, the CDC reported up to 10,000 deaths among adults 60 and older, and those most at risk for severe RSV infection were those living in long-term care facilities and , people with pre-existing lung, heart, or kidney disease or immunosuppression. Mr. Wang said.

“This report confirms similar severe adverse cardiovascular outcomes for RSV observed with other acute respiratory pathogens, such as influenza and SARS-CoV-2, and these are at least associated with infection-related metabolic “It’s caused by stress and myocardial stress, but other factors may also be involved,” Wang explained. “It’s a more direct pathogen-mediated effect.”

Pathogen-mediated effects associated with RSV include increased cytokine-related inflammatory responses that contribute to coronary plaque destabilization, hypercoagulability leading to increased risk of thrombosis, and physiological and metabolic effects associated with acute respiratory illness. Stress-induced demand ischemia and direct myocardial damage may include, Dr. Woodruff said. the group pointed out.

Woodruff et al.’s cross-sectional study analyzed surveillance data from the RSV Hospital Surveillance Network, a CDC program that collects information on hospitalized patients with RSV infection detected by clinician-directed laboratory testing. This study included data on adults 50 and older within 12 states over five seasons of RSV. The researchers estimated weighted period prevalence and 95% confidence intervals for acute cardiac events.

A notable limitation of the study, Woodruff and colleagues say, is that it included only patients with laboratory-confirmed RSV infections. These patients have more severe infections and are therefore more likely to have cardiac events, especially if their symptoms are mild, as not all adults with acute respiratory illness are tested for RSV. There may have been a trend.