Roberto Cangemi1, Marco Falcone2, Gloria Taliani3, Camilla Calvieri4, Giusy Tiseo1, Giulio Francesco Romiti1, Giuliano Bertazzoni5, Alessio Farcomeni2, Francesco Violi1. 1. 1 Department of Internal Medicine and Medical Specialties. 2. 2 Department of Public Health and Infectious Diseases. 3. 3 Infectious and Tropical Diseases Unit, Department of Clinical Medicine. 4. 4 Department of Cardiovascular, Respiratory, Nephrology, Anesthesiology and Geriatric Sciences, and. 5. 5 UOC Emergency Medicine, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy.
Abstract
RATIONALE: Adults hospitalized for community-acquired pneumonia (CAP) have an increased risk of myocardial infarction. Corticosteroid treatment lowers CAP morbidity and mortality, but it is not known whether it influences in-hospital myocardial infarction. OBJECTIVES: The aim of the present study was to investigate the potential interplay between corticosteroid treatment and in-hospital myocardial infarction in adults with CAP. METHODS: We retrospectively analyzed adults with CAP referred to the University Hospital Policlinico Umberto I (Rome, Italy), consecutively recruited, and prospectively followed until discharge. The primary outcome was the occurrence of myocardial infarction during hospitalization. We used propensity score-adjusted Cox models to examine the association between corticosteroid use and myocardial infarction. RESULTS: Seven hundred fifty-eight patients (493 males, 265 females; mean ± standard deviation age, 71.7 ± 14.4 yr) were included in the study. Of these, 241 (32%) were treated with systemic corticosteroids (methylprednisolone, betamethasone, or prednisone). During follow-up, 62 (8.2%) had a myocardial infarction during their hospitalization (incidence, 0.72 per 100 person-days; 95% confidence interval [CI], 0.55 to 0.92). Those treated with corticosteroids had a lower incidence of myocardial infarction (0.42 per 100 person-days) than those not treated with corticosteroids (0.89 per 100 person-days; absolute rate difference, -0.48 per 100 person-days; 95% CI, -0.85 to -0.10). In a propensity score-adjusted Cox model, corticosteroid use was associated with a lower incidence of myocardial infarction (hazard ratio, 0.46; 95% CI, 0.24 to 0.88; P = 0.02). CONCLUSIONS: We found that in-hospital corticosteroid treatment was associated with a lower incidence of myocardial infarction in adults hospitalized with CAP.
RATIONALE: Adults hospitalized for community-acquired pneumonia (CAP) have an increased risk of myocardial infarction. Corticosteroid treatment lowers CAP morbidity and mortality, but it is not known whether it influences in-hospital myocardial infarction. OBJECTIVES: The aim of the present study was to investigate the potential interplay between corticosteroid treatment and in-hospital myocardial infarction in adults with CAP. METHODS: We retrospectively analyzed adults with CAP referred to the University Hospital Policlinico Umberto I (Rome, Italy), consecutively recruited, and prospectively followed until discharge. The primary outcome was the occurrence of myocardial infarction during hospitalization. We used propensity score-adjusted Cox models to examine the association between corticosteroid use and myocardial infarction. RESULTS: Seven hundred fifty-eight patients (493 males, 265 females; mean ± standard deviation age, 71.7 ± 14.4 yr) were included in the study. Of these, 241 (32%) were treated with systemic corticosteroids (methylprednisolone, betamethasone, or prednisone). During follow-up, 62 (8.2%) had a myocardial infarction during their hospitalization (incidence, 0.72 per 100 person-days; 95% confidence interval [CI], 0.55 to 0.92). Those treated with corticosteroids had a lower incidence of myocardial infarction (0.42 per 100 person-days) than those not treated with corticosteroids (0.89 per 100 person-days; absolute rate difference, -0.48 per 100 person-days; 95% CI, -0.85 to -0.10). In a propensity score-adjusted Cox model, corticosteroid use was associated with a lower incidence of myocardial infarction (hazard ratio, 0.46; 95% CI, 0.24 to 0.88; P = 0.02). CONCLUSIONS: We found that in-hospital corticosteroid treatment was associated with a lower incidence of myocardial infarction in adults hospitalized with CAP.
Authors: Michael Resl; Matthias Wolfgang Heinzl; Carmen Klammer; Margot Egger; Roland Feldbauer; Johannes Pohlhammer; Benjamin Dieplinger; Martin Clodi Journal: J Cardiovasc Transl Res Date: 2021-03-22 Impact factor: 4.132
Authors: A Ceccato; A Russo; E Barbeta; P Oscanoa; G Tiseo; A Gabarrus; P Di Giannatale; S Nogas; C Cilloniz; F Menichetti; M Ferrer; M Niederman; M Falcone; A Torres Journal: Crit Care Date: 2021-12-16 Impact factor: 9.097