Biomarkers in Community-Acquired Pneumonia (Cardiac and Non-Cardiac)

Méndez, Raúl; Aldás, Irene; Menéndez, Rosário

doi:10.3390/jcm9020549

Cited by 19 publications

(14 citation statements)

References 128 publications

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“…Mortality at 1 year after a case of CAP is high and it is thought that the cause may lie in a state of persistent chronic inflammation that leads to a greater number of cardiovascular events and higher long-term mortality [29][30][31][32][33]. Undoubtedly, knowing the kinetics of biomarkers is crucial to measure the evolution of inflammation, proADM being the one biomarker that has shown the best results [26,34]. For that reason, the evolution of biomarkers from day 5 to day 30 was analyzed to assess the impact of the intervention on inflammation and consequently, on cardiovascular events at late follow-up.…”

Section: Discussionmentioning

confidence: 99%

Impact of reducing the duration of antibiotic treatment on the long-term prognosis of community acquired pneumonia

et al. 2020

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Background The optimal duration of antibiotic treatment for community-acquired pneumonia (CAP) is not well established. The aim of this study was to assess the impact of reducing the duration of antibiotic treatment on long-term prognosis in patients hospitalized with CAP. Methods This was a multicenter study assessing complications developed during 1 year of patients previously hospitalized with CAP who had been included in a randomized clinical trial concerning the duration of antibiotic treatment. Mortality at 90 days, at 180 days and at 1 year was analyzed, as well as new admissions and cardiovascular complications. A subanalysis was carried out in one of the hospitals by measuring C-reactive protein (CRP), procalcitonin (PCT) and proadrenomedullin (proADM) at admission, at day 5 and at day 30. Results A total of 312 patients were included, 150 in the control group and 162 in the intervention group. Ninety day, 180 day and 1-year mortality in the per-protocol analysis were 8 (2.57%), 10 (3.22%) and 14 (4.50%), respectively. There were no significant differences between both groups in terms of 1-year mortality (p = 0.94), new admissions (p = 0.84) or cardiovascular events (p = 0.33). No differences were observed between biomarker level differences from day 5 to day 30 (CRP p = 0.29; PCT p = 0.44; proADM p = 0.52). Conclusions Reducing antibiotic treatment in hospitalized patients with CAP based on clinical stability criteria is safe, without leading to a greater number of long-term complications.

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Section: Discussionmentioning

confidence: 99%

Impact of reducing the duration of antibiotic treatment on the long-term prognosis of community acquired pneumonia

et al. 2020

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“…A high BNP level is related to acute respiratory distress syndrome, sepsis, and congestive heart failure and contributes to higher mortality in patients with pneumonia (25,26). PCT, as an indicator for bacterial coinfection, is approved by the US Food and Drug Administration to guide antibiotic treatment for suspected lower respiratory tract infections (27).…”

Section: Discussionmentioning

confidence: 99%

Comparative Characterization and Risk Stratification of Asymptomatic and Presymptomatic Patients With COVID-19

et al. 2021

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The identification of asymptomatic, non-severe presymptomatic, and severe presymptomatic coronavirus disease 2019 (COVID-19) in patients may help optimize risk-stratified clinical management and improve prognosis. This single-center case series from Wuhan Huoshenshan Hospital, China, included 2,980 patients with COVID-19 who were hospitalized between February 4, 2020 and April 10, 2020. Patients were diagnosed as asymptomatic (n = 39), presymptomatic (n = 34), and symptomatic (n = 2,907) upon admission. This study provided an overview of asymptomatic, presymptomatic, and symptomatic COVID-19 patients, including detection, demographics, clinical characteristics, and outcomes. Upon admission, there was no significant difference in clinical symptoms and CT image between asymptomatic and presymptomatic patients for diagnosis reference. The mean area under the receiver operating characteristic curve (AUC) of the differential diagnosis model to discriminate presymptomatic patients from asymptomatic patients was 0.89 (95% CI, 0.81-0.98). Importantly, the severe and non-severe presymptomatic patients can be further stratified (AUC = 0.82). In conclusion, the two-step risk-stratification model based on 10 laboratory indicators can distinguish among asymptomatic, severe presymptomatic, and non-severe presymptomatic COVID-19 patients on admission. Moreover, single-cell data analyses revealed that the CD8+T cell exhaustion correlated to the progression of COVID-19.

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“…Cardiac troponin rates have been associated with short-term mortality in several series, while its long-term prognostic value is more debatable [ 41 ]. Other CV biomarkers, including NT-proBNP, could have superior prognostic value in the long term [ 19 ], especially when coupled with other biomarkers [ 42 ] or prognostic indexes [ 43 ].…”

Section: Discussionmentioning

confidence: 99%

Troponin Elevation in Older Patients with Acute Pneumonia: Frequency and Prognostic Value

Putot

Bouhey

Tetu

et al. 2020

JCM

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Cardiovascular (CV) events are particularly frequent after acute pneumonia (AP) in the elderly. We aimed to assess whether cardiac troponin I, a specific biomarker of myocardial injury, independently predicts CV events and death after AP in older inpatients. Among 214 consecutive patients with AP aged ≥75 years admitted to a university hospital, 171 with a cardiac troponin I sample in the 72 h following diagnosis of AP were included, and 71 (42%) were found to have myocardial injury (troponin > 100 ng/L). Patients with and without myocardial injury were similar in terms of age, gender and comorbidities, but those with myocardial injury had more severe clinical presentation (median (interquartile range) Pneumonia Severity Index: 60 (40–95) vs. 45 (30–70), p = 0.003). Myocardial injury was strongly associated with in-hospital myocardial infarction (25% vs. 0%, p < 0.001), CV mortality (11 vs. 1%, p = 0.003) and all-cause mortality (34 vs. 13%, p = 0.002). After adjustment for confounders, myocardial injury remained a strong predictive factor of in-hospital mortality (odds ratio (95% confidence interval): 3.32 (1.42–7.73), p = 0.005) but not one-year mortality (1.61 (0.77–3.35), p = 0.2). Cardiac troponin I elevation, a specific biomarker of myocardial injury, was found in nearly half of an unselected cohort of older inpatients with AP and was associated with a threefold risk of in-hospital death.

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Biomarkers in Community-Acquired Pneumonia (Cardiac and Non-Cardiac)

Cited by 19 publications

References 128 publications

Impact of reducing the duration of antibiotic treatment on the long-term prognosis of community acquired pneumonia

Impact of reducing the duration of antibiotic treatment on the long-term prognosis of community acquired pneumonia

Comparative Characterization and Risk Stratification of Asymptomatic and Presymptomatic Patients With COVID-19

Troponin Elevation in Older Patients with Acute Pneumonia: Frequency and Prognostic Value

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