Community-Acquired Pneumonia Patients at Risk for Early and Long-term Cardiovascular Events Are Identified by Cardiac Biomarkers

Menéndez, Rosário; Méndez, Raúl; Aldás, Irene; Reyes, Soledad; González-Jiménez, Paula; España, Pedro Pablo; Almirall, Jordi; Alonso, Ricardo; Suescún, Marta; Dolz, Luis Martínez; Torres, Antoni

doi:10.1016/j.chest.2019.06.040

Cited by 46 publications

(50 citation statements)

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“…The risk factors associated with cardiac events in CAP are infection with S. pneumoniae, older age, severe pneumonia, obesity, hyperlipidemia, and arterial hypertension [35,38,39]. Between 10% and 30% of patients with bacteremic pneumococcal CAP present cardiovascular events, the most affected being those with preexisting cardiovascular disease [38][39][40]. A possible explanation for this cardiac tissue damage is that the substances produced, including Damage-Associated Molecular Patterns (DAMPs), may maintain inflammation during severe lung tissue cell injury, thus affecting other host cells and aggravating heart cell injury [41].…”

Section: Cap Affects Everyone: Why Do We Not Recognize the Threat?mentioning

confidence: 99%

Defining Community-Acquired Pneumonia as a Public Health Threat: Arguments in Favor from Spanish Investigators

et al. 2020

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Despite advances in its prevention, pneumonia remains associated with high morbidity, mortality, and health costs worldwide. Studies carried out in the last decade have indicated that more patients with community-acquired pneumonia (CAP) now require hospitalization. In addition, pneumonia management poses many challenges, especially due to the increase in the number of elderly patients with multiple comorbidities, antibiotic-resistant pathogens, and the difficulty of rapid diagnosis. In this new call to action, we present a wide-ranging review of the information currently available on CAP and offer some reflections on ways to raise awareness of this disease among the general public. We discuss the burden of CAP and the importance of attaining better, faster microbiological diagnosis and initiating appropriate treatment. We also suggest that closer cooperation between health professionals and the population at large could improve the management of this largely preventable infectious disease that takes many lives each year.

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Section: Cap Affects Everyone: Why Do We Not Recognize the Threat?mentioning

confidence: 99%

Defining Community-Acquired Pneumonia as a Public Health Threat: Arguments in Favor from Spanish Investigators

et al. 2020

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“…The usefulness of natriuretic peptides to predict CVE in CAP, specifically MR-proADM, was recently evaluated to identify patients at risk of early and long-term CVE. In that study, those patients with NT-proBNP levels above 1619 pg/mL at day 1 had more than a twofold-increased risk of early CVE, and levels above 315 pg/mL at day 30 day for CV events during one year [12].…”

Section: Natriuretic Peptidesmentioning

confidence: 88%

“…Moreover, troponins could be used to predict cardiac events during and after CAP. Thus, patients with initial levels of troponin above 21.9 ng/L had a twofold-increased risk of CVE within the first 30 days [12]. However, at day 30 (when myocardial damaged is established and the fibrous tissue has already replaced dead cardiomyocytes) troponin T levels failed to predict CVE beyond that time.…”

Section: Troponinsmentioning

confidence: 96%

“…Menéndez R et al [12] Prospective, observational and multicentre in CAP 730 Short and long-term cardiovascular events…”

Section: Mr-proadmmentioning

confidence: 99%

“…Stratification of the risk of mortality due to pneumonia, as well as identifying those patients most susceptible to complications in the short and long-term, are key in establishing preventive strategies and optimizing treatment [8]. Biomarkers in CAP could be useful for the diagnosis of infection [9,10], severity assessment [11], to monitor clinical response and antibiotic duration, and recently, to predict cardiovascular complications [12]. Many biomarkers have been studied for these purposes.…”

Section: Introductionmentioning

confidence: 99%

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

Méndez

Aldás

Menéndez

2020

JCM

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Community-acquired pneumonia (CAP) remains the first cause of morbidity and mortality worldwide due to infection. Several aspects such as severity and host response are related to its clinical course and outcome. Beyond the acute implications that the infection provokes in the host, pneumonia also has long-term negative consequences. Among them, cardiovascular complications and mortality are the most outstanding. Therefore, an adequate recognition and stratification of the risk of complications and mortality is crucial. Many biomarkers have been studied for these reasons, considering that each biomarker mirrors a different aspect. Moreover, the clinical application of many of them is still being deliberated because of their limitations and the heterogeneity of the disease. In this review, we examine some of the most relevant biomarkers that we have classified as cardiac and non-cardiac. We discuss some classic biomarkers and others that are considered novel biomarkers, which are mainly involved in cardiovascular risk.

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Association between advanced lung cancer inflammation index and in‐hospital mortality in ICU patients with community‐acquired pneumonia: A retrospective analysis of the MIMIC‐IV database

Yang,

Gao,

et al. 2024

Aging Medicine

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ObjectiveThe objective of the present study was to explore the correlation between the advanced lung cancer inflammation index (ALI) and in‐hospital mortality among patients diagnosed with community‐acquired pneumonia (CAP).MethodsData from the Medical Information Mart for Intensive Care‐IV database were adopted to analyze the in‐hospital mortality of ICU patients with CAP. Upon admission to the ICU, fundamental data including vital signs, critical illness scores, comorbidities, and laboratory results, were collected. The in‐hospital mortality of all CAP patients was documented. Multivariate logistic regression (MLR) models and restricted cubic spline (RCS) analysis together with subgroup analyses were conducted.ResultsThis study includes 311 CAP individuals, involving 218 survivors as well as 93 nonsurvivors. The participants had an average age of 63.57 years, and the females accounted for approximately 45.33%. The in‐hospital mortality was documented to be 29.90%. MLR analysis found that ALI was identified as an independent predictor for in‐hospital mortality among patients with CAP solely in the Q1 group with ALI ≤ 39.38 (HR: 2.227, 95% CI: 1.026–4.831, P = 0.043). RCS analysis showed a nonlinear relationship between the ALI and in‐hospital mortality, with a turning point at 81, and on the left side of the inflection point, a negative correlation was observed between ALI and in‐hospital mortality (HR: 0.984, 95% CI: 0.975–0.994, P = 0.002). The subgroup with high blood pressure showed significant interaction with the ALI.ConclusionThe present study demonstrated a nonlinear correlation of the ALI with in‐hospital mortality among individuals with CAP. Additional confirmation of these findings requires conducting larger prospective investigations.

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Community-Acquired Pneumonia Patients at Risk for Early and Long-term Cardiovascular Events Are Identified by Cardiac Biomarkers

Cited by 46 publications

References 36 publications

Defining Community-Acquired Pneumonia as a Public Health Threat: Arguments in Favor from Spanish Investigators

Defining Community-Acquired Pneumonia as a Public Health Threat: Arguments in Favor from Spanish Investigators

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

Association between advanced lung cancer inflammation index and in‐hospital mortality in ICU patients with community‐acquired pneumonia: A retrospective analysis of the MIMIC‐IV database

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