Irene Aldás1, Rosario Menéndez2, Raúl Méndez1, Pedro Pablo España3, Jordi Almirall4, Luis Boderías5, Olga Rajas6, Rafael Zalacaín7, Montserrat Vendrell8, Isabel Mir9, Antoni Torres10. 1. Servicio de Neumología, Hospital Universitario y Politécnico La Fe/Instituto de Investigación Sanitaria (IIS) La Fe, Universidad de Valencia, Valencia, España. 2. Servicio de Neumología, Hospital Universitario y Politécnico La Fe/Instituto de Investigación Sanitaria (IIS) La Fe, Universidad de Valencia, Valencia, España. Electronic address: rosmenend@gmail.com. 3. Servicio de Neumología, Hospital de Galdakao-Usansolo, Galdakao, España. 4. Servicio de Medicina Intensiva, Hospital de Mataró, Mataró, España. 5. Servicio de Neumología, Hospital San Jorge, Huesca, España. 6. Servicio de Neumología, Hospital de la Princesa, Madrid, España. 7. Servicio de Neumología, Hospital de Cruces, Bilbao, España. 8. Servicio de Neumología, Hospital Universitario Josep Trueta/Institut d'Investigació Biomèdica de Girona (IDIBGI), Universidad de Girona, Girona, España. 9. Servicio de Neumología, Hospital Son Llàtzer, Palma de Mallorca, España. 10. Servicio de Neumología, Hospital Clínic/Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universidad de Barcelona, Barcelona, España.
Abstract
INTRODUCTION: Community-acquired pneumonia increases the risk of cardiovascular events (CVE). The objective of this study was to analyze host, severity, and etiology factors associated with the appearance of early and late events and their impact on mortality. METHOD: Prospective multicenter cohort study in patients hospitalized for pneumonia. CVE and mortality rates were collected at admission, 30-day follow-up (early events), and one-year follow-up (late events). RESULTS: In total, 202 of 1,967 (10.42%) patients presented early CVE and 122 (6.64%) late events; 16% of 1-year mortality was attributed to cardiovascular disease. The host risk factors related to cardiovascular complications were: age ≥65 years, smoking, and chronic heart disease. Alcohol abuse was a risk factor for early events, whereas obesity, hypertension, and chronic renal failure were related to late events. Severe sepsis and Pneumonia Severity Index (PSI) ≥3 were independent risk factors for early events, and only PSI ≥3 for late events. Streptococcus pneumoniae was the microorganism associated with most cardiovascular complications. Developing CVE was an independent factor related to early (OR 2.37) and late mortality (OR 4.05). CONCLUSIONS: Age, smoking, chronic heart disease, initial severity, and S. pneumoniae infection are risk factors for early and late events, complications that have been related with an increase of the mortality risk during and after the pneumonia episode. Awareness of these factors can help us make active and early diagnoses of CVE in hospitalized CAP patients and design future interventional studies to reduce cardiovascular risk.
INTRODUCTION: Community-acquired pneumonia increases the risk of cardiovascular events (CVE). The objective of this study was to analyze host, severity, and etiology factors associated with the appearance of early and late events and their impact on mortality. METHOD: Prospective multicenter cohort study in patients hospitalized for pneumonia. CVE and mortality rates were collected at admission, 30-day follow-up (early events), and one-year follow-up (late events). RESULTS: In total, 202 of 1,967 (10.42%) patients presented early CVE and 122 (6.64%) late events; 16% of 1-year mortality was attributed to cardiovascular disease. The host risk factors related to cardiovascular complications were: age ≥65 years, smoking, and chronic heart disease. Alcohol abuse was a risk factor for early events, whereas obesity, hypertension, and chronic renal failure were related to late events. Severe sepsis and Pneumonia Severity Index (PSI) ≥3 were independent risk factors for early events, and only PSI ≥3 for late events. Streptococcus pneumoniae was the microorganism associated with most cardiovascular complications. Developing CVE was an independent factor related to early (OR 2.37) and late mortality (OR 4.05). CONCLUSIONS: Age, smoking, chronic heart disease, initial severity, and S. pneumoniae infection are risk factors for early and late events, complications that have been related with an increase of the mortality risk during and after the pneumonia episode. Awareness of these factors can help us make active and early diagnoses of CVE in hospitalized CAP patients and design future interventional studies to reduce cardiovascular risk.
Authors: Leah B Kosyakovsky; Federico Angriman; Emma Katz; Neill K Adhikari; Lucas C Godoy; John C Marshall; Bruno L Ferreyro; Douglas S Lee; Robert S Rosenson; Naveed Sattar; Subodh Verma; Augustin Toma; Marina Englesakis; Barry Burstein; Michael E Farkouh; Margaret Herridge; Dennis T Ko; Damon C Scales; Michael E Detsky; Lior Bibas; Patrick R Lawler Journal: Intensive Care Med Date: 2021-08-09 Impact factor: 17.440
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