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. 2025 May 28;25(1):410.
doi: 10.1186/s12872-025-04874-7.

Effect of constipation on hospitalization due to heart failure in patients after myocardial infarction: a retrospective cohort study

Shigeto Namiuchi  1 , Shinichiro Sunamura  2 , Atsushi Tanita  2 , Tsuyoshi Ogata  2 , Kazuki Noda  2 , Toru Takii  2 , Yoshio Nitta  3 , Seijiro Yoshida  3
Affiliations

Effect of constipation on hospitalization due to heart failure in patients after myocardial infarction: a retrospective cohort study

Shigeto Namiuchi et al. BMC Cardiovasc Disord. .

Abstract

Background: Patients with constipation after acute heart failure (HF) are at high risk of rehospitalization due to HF. Although HF after myocardial infarction (MI) affects patient outcomes, the relationship between constipation and patient prognosis after MI remains unclear. In this study, we evaluated the effects of constipation on the prognosis of patients with MI, focusing on hospitalization due to HF.

Methods: We investigated 1,324 patients with MI admitted to our hospital between January 2012 and December 2023 (mean age, 68 ± 14 years; 76% males). Patients with constipation were defined as those using laxatives regularly.

Results: During the follow-up period (median, 2.7 years), 115 patients died, and 99 were re-hospitalized due to HF. Landmark Kaplan-Meier analyses revealed incidences of 7.8% and 2.1% hospitalization due to HF from 0 to 0.5 years (log-rank: p < 0.0001) and 4.8% and 3.9% from 0.5 to 3 years (log-rank: p = 0.17) among patients with and without constipation, respectively. The adjusted Cox proportional hazards analysis revealed a significantly higher risk of hospitalization due to HF from 0 to 0.5 years in patients with constipation than in those without it (hazard ratio, 2.12; 95% confidence interval, 1.07-4.19; p = 0.032). However, no significant difference was found from 0.5 to 3 years (hazard ratio, 0.86; 95% confidence interval, 0.47-1.57; p = 0.63).

Conclusions: Constipation was strongly associated with a higher risk of hospitalization due to HF in patients with MI during the first 6 months after discharge.

Keywords: Constipation; Heart failure; Hospitalization; Myocardial infarction; Prognosis.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study conformed to the principles outlined in the Declaration of Helsinki and was approved by the Ethics Committee of Sendai City Medical Center (approval number: 2024-0059). Informed consent for this study was obtained on an opt-out basis. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests. Clinical trial number: Not applicable.

Figures

Fig. 1
Fig. 1
Kaplan–Meier curves for all-cause death and HF hospitalization after MI. Kaplan-Meier curves for all-cause death and hospitalization due to HF in patients with and without constipation after MI before propensity score matching. Solid lines represent patients with constipation, and dotted lines represent those without constipation. The log-rank p-values are shown. HF, heart failure; MI, myocardial infarction
Fig. 2
Fig. 2
Landmark analysis for all-cause death before propensity score matching. Landmark analysis showing the cumulative incidence of all-cause death at 0–0.5 years and 0.5–3 years in patients with and without constipation after MI, before propensity score matching. Solid lines represent patients with constipation, and dotted lines represent those without constipation. The log-rank p-values are shown. MI, myocardial infarction
Fig. 3
Fig. 3
Landmark analysis for HF hospitalization before propensity score matching. Landmark analysis showing the cumulative incidence of hospitalization due to HF at 0–0.5 years and 0.5–3 years in patients with and without constipation after MI, before propensity score matching. Solid lines represent patients with constipation, and dotted lines represent those without constipation. The log-rank p-values are shown. The multivariable-adjusted hazard ratio for heart failure hospitalization within 0–0.5 years is 2.12 (95% CI, 1.07–4.19; p = 0.032). HF, heart failure; MI, myocardial infarction; CI, confidence interval
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