1. Community-Acquired Pneumonia Patients at Risk for Early and Long-term Cardiovascular Events Are Identified by Cardiac Biomarkers
- Author
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Rosario Menéndez, Paula González-Jiménez, Ricardo Alonso, Raúl Méndez, Marta Suescun, Jordi Almirall, Soledad Reyes, Antoni Torres, Pedro Pablo España, Luis Martínez-Dolz, and Irene Aldás
- Subjects
Pulmonary and Respiratory Medicine ,Male ,medicine.medical_specialty ,Time Factors ,medicine.drug_class ,Critical Care and Intensive Care Medicine ,Risk Assessment ,Procalcitonin ,03 medical and health sciences ,0302 clinical medicine ,Community-acquired pneumonia ,Internal medicine ,Natriuretic peptide ,Pneumonia, Bacterial ,Medicine ,Humans ,030212 general & internal medicine ,Myocardial infarction ,Prospective Studies ,Aged ,Aged, 80 and over ,biology ,Troponin T ,business.industry ,C-reactive protein ,Middle Aged ,medicine.disease ,Troponin ,Community-Acquired Infections ,Pneumonia ,030228 respiratory system ,Cardiovascular Diseases ,biology.protein ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Biomarkers - 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, Pa o 2/F io 2 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.
- Published
- 2019