Allen T Griffin1, Timothy L Wiemken, Forest W Arnold. 1. School of Medicine, Department of Medicine, Division of Infectious Diseases, University of Louisville, 501 East Broadway, Suite 380, Louisville, KY 40292, USA. Electronic address: atgrif01@louisville.edu.
Abstract
BACKGROUND: An increased risk of cardiovascular complications has been found in those with community-acquired pneumonia (CAP). Preliminary data suggest that pneumococcal pneumonia, more severe pneumonia, older age, renal disease, hypoalbuminemia, and inpatient sliding scale insulin administration contribute to risk. The objective of this study was to ascertain additional factors influencing cardiovascular events in CAP. METHODS: This investigation was a retrospective cohort study of inpatients with CAP. Outcomes evaluated were development of a cardiovascular event during hospitalization, defined as acute pulmonary edema, cardiac arrhythmia, or myocardial infarction. Those with and without events were compared across cardiovascular- and pneumonia-specific variables by logistic regression to ascertain factors that independently increase risk or reduce risk. RESULTS: Of 3068 inpatients with pneumonia, 376 (12%) developed a cardiovascular event. Hyperlipidemia, more severe pneumonia, and Staphylococcus aureus or Klebsiella pneumoniae as etiologies were associated with increased risk, while statin use was associated with decreased risk. CONCLUSIONS: This study highlights variables in CAP patients that should make clinicians vigilant for the development of cardiac complications. Additional research is needed to determine if statins attenuate cardiac risk in CAP.
BACKGROUND: An increased risk of cardiovascular complications has been found in those with community-acquired pneumonia (CAP). Preliminary data suggest that pneumococcal pneumonia, more severe pneumonia, older age, renal disease, hypoalbuminemia, and inpatient sliding scale insulin administration contribute to risk. The objective of this study was to ascertain additional factors influencing cardiovascular events in CAP. METHODS: This investigation was a retrospective cohort study of inpatients with CAP. Outcomes evaluated were development of a cardiovascular event during hospitalization, defined as acute pulmonary edema, cardiac arrhythmia, or myocardial infarction. Those with and without events were compared across cardiovascular- and pneumonia-specific variables by logistic regression to ascertain factors that independently increase risk or reduce risk. RESULTS: Of 3068 inpatients with pneumonia, 376 (12%) developed a cardiovascular event. Hyperlipidemia, more severe pneumonia, and Staphylococcus aureus or Klebsiella pneumoniae as etiologies were associated with increased risk, while statin use was associated with decreased risk. CONCLUSIONS: This study highlights variables in CAP patients that should make clinicians vigilant for the development of cardiac complications. Additional research is needed to determine if statins attenuate cardiac risk in CAP.
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