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. 2015 Sep 15;1(1):00020-2015.
doi: 10.1183/23120541.00020-2015. eCollection 2015 May.

Acute myocardial infarction versus other cardiovascular events in community-acquired pneumonia

Stefano Aliberti  1 , Julio Ramirez  2 , Roberto Cosentini  3 , Vincenzo Valenti  4 , Antonio Voza  5 , Paolo Rossi  6 , Daiana Stolz  7 , Delfino Legnani  8 , Alberto Pesci  1 , Luca Richeldi  9 , Paula Peyrani  2 , Fernando Maria Massari  10 , Francesco Blasi  11
Affiliations

Acute myocardial infarction versus other cardiovascular events in community-acquired pneumonia

Stefano Aliberti et al. ERJ Open Res. .

Abstract

The aim of the present study was to define the prevalence, characteristics, risk factors and impact on clinical outcomes of acute myocardial infarction (AMI) versus other cardiovascular events (CVEs) in patients with community-acquired pneumonia (CAP). This was an international, multicentre, observational, prospective study of CAP patients hospitalised in eight hospitals in Italy and Switzerland. Three groups were identified: those without CVEs, those with AMI and those with other CVEs. Among 905 patients, 21 (2.3%) patients experienced at least one AMI, while 107 (11.7%) patients experienced at least one other CVE. Patients with CAP and either AMI or other CVEs showed a higher severity of the disease than patients with CAP alone. Female sex, liver disease and the presence of severe sepsis were independent predictors for the occurrence of AMI, while female sex, age >65 years, neurological disease and the presence of pleural effusion predicted other CVEs. In-hospital mortality was significantly higher among those who experienced AMI in comparison to those experiencing other CVEs (43% versus 21%, p=0.039). The presence of AMI showed an adjusted odds ratio for in-hospital mortality of 3.57 (p=0.012) and for other CVEs of 2.63 (p=0.002). These findings on AMI versus other CVEs as complications of CAP may be important when planning interventional studies on cardioprotective medications.

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Conflict of interest statement

can be found alongside this article at openres.ersjournals.com

Figures

FIGURE 1
FIGURE 1
Prevalence of acute myocardial infarction (AMI) or other cardiovascular events (CVEs) according to a) Pneumonia Severity Index (PSI) risk classes and b) CURB-65 Score. ***: p<0.001 across PSI risk classes; #: p=0.014 across CURB-65 scores; : p=0.001 across CURB-65 score; +: p<0.001 across CURB-65 scores.
FIGURE 2
FIGURE 2
Prevalence of acute myocardial infarction (AMI) or other cardiovascular events (CVEs) according to the presence of acute respiratory failure (ARF) and severe sepsis (SS) on hospital admission. ***: p<0.001 across the three groups.
FIGURE 3
FIGURE 3
Clinical outcomes of the study population according to the three study groups. CVE: cardiovascular event; AMI: acute myocardial infarction. *: p<0.001 across the three groups.
FIGURE 4
FIGURE 4
Multivariable logistic regression analysis for in-hospital mortality among the study population. Whiskers represented 95% confidence intervals. PSI: Pneumonia Severity Index.
See this image and copyright information in PMC

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