Rosario Menéndez1, Raúl Méndez2, Irene Aldás3, Soledad Reyes2, Paula Gonzalez-Jimenez2, Pedro Pablo España4, Jordi Almirall5, Ricardo Alonso6, Marta Suescun6, Luis Martinez-Dolz7, Antoni Torres8. 1. Pneumology Department, Hospital Universitario y Politécnico La Fe/Instituto de Investigación Sanitaria La Fe, Valencia, Spain; Center for Biomedical Research Network in Respiratory Diseases (CIBERES, CB06/06/0028), Madrid, Spain; University of Valencia, Valencia, Spain. Electronic address: rosmenend@gmail.com. 2. Pneumology Department, Hospital Universitario y Politécnico La Fe/Instituto de Investigación Sanitaria La Fe, Valencia, Spain. 3. Pneumology Department, Hospital Universitario y Politécnico La Fe/Instituto de Investigación Sanitaria La Fe, Valencia, Spain; University of Valencia, Valencia, Spain. 4. Pneumology Department, Hospital de Galdakao-Usansolo, Galdakao, Spain. 5. Intensive Care Unit, Hospital de Mataró, Barcelona, Spain; Center for Biomedical Research Network in Respiratory Diseases (CIBERES, CB06/06/0028), Madrid, Spain. 6. Laboratory Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain. 7. Heart Failure and Transplantation Unit, Cardiology Department, Hospital Universitario y Politécnico La Fe/Instituto de Investigación Sanitaria La Fe, Valencia, Spain; Center for Biomedical Research Network in Cardiovascular Diseases (CIBERCV, CB16/11/00261), Madrid, Spain. 8. Pneumology Department, Hospital Clínic/Institut D'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain; Center for Biomedical Research Network in Respiratory Diseases (CIBERES, CB06/06/0028), Madrid, Spain.
Abstract
BACKGROUND: Community-acquired pneumonia (CAP) increases the risk of cardiovascular complications during and following the episode. The goal of this study was to determine the usefulness of cardiovascular and inflammatory biomarkers for assessing the risk of early (within 30 days) or long-term (1-year follow-up) cardiovascular events. METHODS: A total of 730 hospitalized patients with CAP were prospectively followed up during 1 year. Cardiovascular (proadrenomedullin [proADM], pro-B-type natriuretic peptide (proBNP), proendothelin-1, and troponin T) and inflammatory (interleukin 6 [IL-6], C-reactive protein, and procalcitonin) biomarkers were measured on day 1, at day 4/5, and at day 30. RESULTS: Ninety-two patients developed an early event, and 67 developed a long-term event. Significantly higher initial levels of proADM, proendothelin-1, troponin, proBNP, and IL-6 were recorded in patients who developed cardiovascular events. Despite a decrease at day 4/5, levels remained steady until day 30 in those who developed late events. Biomarkers (days 1 and 30) independently predicted cardiovascular events adjusted for age, previous cardiac disease, Pao2/Fio2 < 250 mm Hg, and sepsis: ORs (95% CIs), proendothelin-1, 2.25 (1.34-3.79); proADM, 2.53 (1.53-4.20); proBNP, 2.67 (1.59-4.49); and troponin T, 2.70 (1.62-4.49) for early events. For late events, the ORs (95% CIs) were: proendothelin-1, 3.13 (1.41-7.80); proADM, 2.29 (1.01-5.19); and proBNP, 2.34 (1.01-5.56). Addition of IL-6 levels at day 30 to proendothelin-1 or proADM increased the ORs to 3.53 and 2.80, respectively. CONCLUSIONS: Cardiac biomarkers are useful for identifying patients with CAP at high risk for early and long-term cardiovascular events. They may aid personalized treatment optimization and for designing future interventional studies to reduce cardiovascular risk.
BACKGROUND: Community-acquired pneumonia (CAP) increases the risk of cardiovascular complications during and following the episode. The goal of this study was to determine the usefulness of cardiovascular and inflammatory biomarkers for assessing the risk of early (within 30 days) or long-term (1-year follow-up) cardiovascular events. METHODS: A total of 730 hospitalized patients with CAP were prospectively followed up during 1 year. Cardiovascular (proadrenomedullin [proADM], pro-B-type natriuretic peptide (proBNP), proendothelin-1, and troponin T) and inflammatory (interleukin 6 [IL-6], C-reactive protein, and procalcitonin) biomarkers were measured on day 1, at day 4/5, and at day 30. RESULTS: Ninety-two patients developed an early event, and 67 developed a long-term event. Significantly higher initial levels of proADM, proendothelin-1, troponin, proBNP, and IL-6 were recorded in patients who developed cardiovascular events. Despite a decrease at day 4/5, levels remained steady until day 30 in those who developed late events. Biomarkers (days 1 and 30) independently predicted cardiovascular events adjusted for age, previous cardiac disease, Pao2/Fio2 < 250 mm Hg, and sepsis: ORs (95% CIs), proendothelin-1, 2.25 (1.34-3.79); proADM, 2.53 (1.53-4.20); proBNP, 2.67 (1.59-4.49); and troponin T, 2.70 (1.62-4.49) for early events. For late events, the ORs (95% CIs) were: proendothelin-1, 3.13 (1.41-7.80); proADM, 2.29 (1.01-5.19); and proBNP, 2.34 (1.01-5.56). Addition of IL-6 levels at day 30 to proendothelin-1 or proADM increased the ORs to 3.53 and 2.80, respectively. CONCLUSIONS: Cardiac biomarkers are useful for identifying patients with CAP at high risk for early and long-term cardiovascular events. They may aid personalized treatment optimization and for designing future interventional studies to reduce cardiovascular risk.
Authors: Hector F Africano; Cristian C Serrano-Mayorga; Paula C Ramirez-Valbuena; Ingrid G Bustos; Alirio Bastidas; Hernan A Vargas; Sandra Gómez; Alejandro Rodriguez; Carlos J Orihuela; Luis F Reyes Journal: Clin Infect Dis Date: 2021-06-01 Impact factor: 9.079
Authors: Charles S Dela Cruz; Scott E Evans; Marcos I Restrepo; Nathan Dean; Antonio Torres; Isabel Amara-Elori; Shanjana Awasthi; Elisabet Caler; Bin Cao; James D Chalmers; Jean Chastre; Taylor S Cohen; Alan H Cohen; Kristina Crothers; Y Peter Di; Marie E Egan; Charles Feldman; Samir Gautam; E Scott Halstead; Susanne Herold; Barbara E Jones; Carlos Luna; Michael S Niederman; Raul Mendez; Rosario Menendez; Joseph P Mizgerd; Roomi Nusrat; Julio Ramirez; Yuichiro Shindo; Grant Waterer; Samantha M Yeligar; Richard G Wunderink Journal: Ann Am Thorac Soc Date: 2021-07