Cardiac Complications in Patients With Community-Acquired Pneumonia

Corrales–Medina, Vicente F.; Musher, Daniel M.; Wells, George A.; Chirinos, Julio A.; Chen, Li; Fine, Michael J.

doi:10.1161/circulationaha.111.040766

Cited by 353 publications

(171 citation statements)

References 35 publications

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“…Observational epidemiological studies have confirmed what experienced clinicians suspected for many years: cardiovascular events can be triggered by a variety of common noncardiovascular clinical conditions, particularly those that are associated with systemic inflammation [1][2][3] . One of the best documented examples of non-infectious systemic inflammation causing an acute increase in cardiovascular risk is major surgery.…”

Section: Introductionmentioning

confidence: 63%

Orthopedic surgery increases atherosclerotic lesions and necrotic core area in ApoE−/− mice

et al. 2016

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Section: Introductionmentioning

confidence: 63%

Orthopedic surgery increases atherosclerotic lesions and necrotic core area in ApoE−/− mice

et al. 2016

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“…Acute lung injury and multi-organ dysfunction syndrome, as well as acute cardiac events mostly occurring early in the course of CAP, have been identified as being significant contributors to mortality [1][2][3][4][5][6][7]. In the case of pneumococcal CAP, an increasing body of evidence, derived from both clinical and experimental studies, has implicated the major cytolytic, cholesterolbinding, pore-forming protein toxin, pneumolysin (Ply), in the pathogenesis of associated adverse pulmonary and cardiovascular events [8][9][10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Pneumolysin Mediates Platelet Activation In Vitro

Nel

Durandt

Mitchell

et al. 2016

Lung

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This study has explored the role of the pneumococcal toxin, pneumolysin (Ply), in activating human platelets. Following exposure to Ply [10-80 nanograms (ng)/ml], platelet activation and cytosolic Ca 2+ concentrations were measured flow cytometrically according to the level of expression of CD62P (P-selectin) and spectrofluorimetrically respectively. Exposure to Ply resulted in marked upregulation of expression of platelet CD62P, achieving statistical significance at concentrations of 40 ng/ml and higher (p<0.05), in the setting of increased influx of Ca 2+ . These potentially pro-thrombotic actions of Ply were attenuated by depletion of Ca 2+ from the extracellular medium, or by exposure of the cells to a pneumolysoid devoid of pore-forming activity. These findings are consistent with a mechanism of Plymediated platelet activation involving sub-lytic pore formation, Ca 2+ influx, and mobilization of CD62P-expressing α-granules, which, if operative in vivo, may contribute to the pathogenesis of associated acute lung and myocardial injury during invasive pneumococcal disease.

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“…Corrales-Medina et al (32) detected the majority of cardiovascular complications in the first week. As these complications have a very early onset, the patient may be in the emergency room, observation area, or short stay ward, thus reasserting the importance of early diagnosis and treatment in the HER but also the need for tools that help predict mortality.…”

Section: Survival Analysismentioning

confidence: 98%