Data on the prevalence of infections in patients who underwent percutaneous coronary
intervention (PCI) and their impact on outcomes are scarce. In this study, a total
of 644 patients ≥80 years of age who underwent PCI were stratified according to the
presence/absence of infections requiring antibiotic therapy. The primary end point
was major adverse cardiovascular events (MACE) after discharge, a composite of all-cause
mortality, nonfatal myocardial infarction, and rehospitalization for heart failure.
Median follow-up was 1.2 (interquartile range 0.1 to 3.4) years. Of the 644 patients,
186 (28.9%) had infections during index hospitalization, with 84 (13%) and 59 (9.2%)
patients having pneumonia and urinary tract infections, respectively. Patients with
infections were older, more often women, and had an increased prevalence of atrial
fibrillation and congestive heart failure. Infections prolonged hospital stay (10
[7 to 16] vs 5 [3 to 7] days, p <0.001), but were not related to rates of MACE (20%
vs 19%, adjusted hazard ratio [HR] 1.41, 95% confidence intervals 0.84 to 2.38, p = 0.20).
Pneumonia was significantly associated with increased rates of MACE (27% vs 18%, adjusted
HR 2.19, 95% confidence intervals 1.23 to 3.91, p = 0.008) and rehospitalization for
heart failure (17% vs 10%, adjusted HR 2.66 (1.25 to 5.63, p = 0.01), whereas urinary
tract infections were not. In conclusion, concomitant infections are frequent in patients
≥80 years of age who underwent PCI, and associated with an increased risk of adverse
events when affecting the respiratory system.
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References
- Temporal trends in the treatment and outcomes of elderly patients with acute coronary syndrome.Eur Heart J. 2016; 37: 1304-1311
- Percutaneous coronary intervention in the elderly.Int J Cardiol. 2015; 199: 342-355
- Resolving inequalities in care? Reduced mortality in the elderly after acute coronary syndromes. The Myocardial Ischaemia National Audit Project 2003-2010.Eur Heart J. 2012; 33: 630-639
- International comparison of treatment and long-term outcomes for acute myocardial infarction in the elderly: Minneapolis/St. Paul, MN, USA and Goteborg, Sweden.Eur Heart J. 2013; 34: 3191-3197
- Impact of age on management and outcome of acute coronary syndrome: observations from the Global Registry of Acute Coronary Events (GRACE).Am Heart J. 2005; 149: 67-73
- The association between older age and receipt of care and outcomes in patients with acute coronary syndromes: a cohort study of the Myocardial Ischaemia National Audit Project (MINAP).Eur Heart J. 2014; 35: 1551-1558
- Effect of physical disability on mortality in elderly patients of >/=80 years of age undergoing percutaneous coronary intervention.Am J Cardiol. 2018; 122: 537-541
- Impact of acute kidney injury in elderly (>/=80 years) patients undergoing percutaneous coronary intervention.J Interv Cardiol. 2018; 31: 792-798
- Risk of acute coronary heart disease after sepsis hospitalization in the reasons for geographic and racial differences in stroke cohort.Clin Infect Dis. 2017; 65: 29-36
- Association between hospitalization for pneumonia and subsequent risk of cardiovascular disease.JAMA. 2015; 313: 264-274
- Risk of cardiovascular events in survivors of severe sepsis.Am J Respir Crit Care Med. 2014; 189: 1065-1074
- Serious infection after acute myocardial infarction: incidence, clinical features, and outcomes.JACC Cardiovasc Interv. 2012; 5: 769-776
- Comparison of outcomes of patients with sepsis with versus without acute myocardial infarction and comparison of invasive versus noninvasive management of the patients with infarction.Am J Cardiol. 2016; 117: 1065-1071
- Serious infections among unselected patients with ST-elevation myocardial infarction treated with contemporary primary percutaneous coronary intervention.Am Heart J. 2016; 181: 52-59
- Lower mortality following pulmonary adverse events and sepsis with ticagrelor compared to clopidogrel in the PLATO study.Platelets. 2014; 25: 517-525
- 2013 ESC guidelines on the management of stable coronary artery disease: the task force on the management of stable coronary artery disease of the European Society of Cardiology.Eur Heart J. 2013; 34: 2949-3003
- 2015 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: task force for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation of the European Society of Cardiology (ESC).Eur Heart J. 2016; 37: 267-315
- ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation.Eur Heart J. 2012; 33: 2569-2619
- An international randomized trial comparing four thrombolytic strategies for acute myocardial infarction. The GUSTO investigators.New Engl J Med. 1993; 329: 673-682
- Risk of myocardial infarction and stroke after acute infection or vaccination.New Engl J Med. 2004; 351: 2611-2618
- Inflammatory markers and onset of cardiovascular events: results from the Health ABC study.Circulation. 2003; 108: 2317-2322
- Inflammatory markers at hospital discharge predict subsequent mortality after pneumonia and sepsis.Am J Respir Crit Care Med. 2008; 177: 1242-1247
- Clinical criteria replenish high-sensitive troponin and inflammatory markers in the stratification of patients with suspected acute coronary syndrome.PLoS One. 2014; 9: e98626
- Elevated hemostasis markers after pneumonia increases one-year risk of all-cause and cardiovascular deaths.PLoS One. 2011; 6: e22847
- Sepsis and the heart.Circulation. 2007; 116: 793-802
- Prevalence and significance of coagulation abnormalities in community-acquired pneumonia.Mol Med. 2009; 15: 438-445
Article Info
Publication History
Published online: March 09, 2019
Received in revised form:
February 24,
2019
Received:
January 8,
2019
Footnotes
Funding: None.
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
