Community-acquired pneumonia (CAP) is complicated by cardiac events in the early phase
of the disease. Aim of this study was to assess if these intrahospital cardiac complications
may account for overall mortality and cardiovascular events occurring during a long-term
follow-up. Three hundred one consecutive patients admitted to the University-Hospital,
Policlinico Umberto I, with community-acquired pneumonia were prospectively recruited
and followed up for a median of 17.4 months. Primary end point was the occurrence
of death for any cause, and secondary end point was the occurrence of cardiovascular
events (cardiovascular death, nonfatal myocardial infarction [MI], and stroke). During
the intrahospital stay, 55 patients (18%) experienced a cardiac complication. Of these,
32 had an MI (29 non–ST-elevation MI and 3 ST-elevation MI) and 30 had a new episode
of atrial fibrillation (7 nonmutually exclusive events). During the follow-up, 89
patients died (51% of patients with an intrahospital cardiac complication and 26%
of patients without, p <0.001) and 73 experienced a cardiovascular event (47% of patients
with and 19% of patients without an intrahospital cardiac complication, p <0.001).
A Cox regression analysis showed that intrahospital cardiac complications, age, and
Pneumonia Severity Index were significantly associated with overall mortality, whereas
intrahospital cardiac complications, age, hypertension, and diabetes were significantly
associated with cardiovascular events during the follow-up. In conclusion, this prospective
study shows that intrahospital cardiac complications in the early phase of pneumonia
are associated with an enhanced risk of death and cardiovascular events during long-term
follow-up.
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Article info
Publication history
Published online: May 21, 2015
Accepted:
May 14,
2015
Received in revised form:
May 14,
2015
Received:
March 31,
2015
Footnotes
See page 650 for disclosure information.
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Copyright
© 2015 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
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Access this article on ScienceDirectLinked Article
- Cardiac Complications After Community-Acquired PneumoniaAmerican Journal of CardiologyVol. 117Issue 2
- PreviewWe read with interest the report by Cangemi et al1 “Relation of cardiac complications in the early phase of community-acquired pneumonia (CAP) to long-term mortality and cardiovascular events” published in the August 5th issue of the American Journal of Cardiology. The investigators show that 18% of patients with CAP study develop intrahospital cardiac complications, defined as myocardial infarction (MI) and atrial fibrillation. Furthermore, the investigators prospectively show that these cardiac complications in the early phase of CAP are associated with adverse long-term cardiovascular prognosis (with the end point being cardiovascular death, nonfatal MI, and stroke).
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