Abstract
Objective: To determine if patients with community acquired pneumonia (CAP) are at increased risk of vascular events following discharge.
Methods: Patients enrolled in a prospective study for CAP who survived to hospital discharge were followed up at 1 year. A cohort matched to age, sex, co-morbidities and vascular risk factors were included and the incidence of vascular events and mortality were recorded.
Results: 1321 patients were included (50.3% male, median age 65 (IQR 48-77), 23.7% had a prior history cardiovascular events) with 1321 matched controls. 12.3% of CAP patients died after discharge by 1 year, with 28.9% attributed to cardiovascular events or stroke. The incidence increased with age.
156 patients required hospitalisation within 1 year for one or more vascular event; myocardial infarction (MI) n=74, cardiac failure n=61, for cardiac arrhythmia n=31 and stroke n=12. Of the 74 patients with MI, there was a significantly increased incidence when compared to the control group (fig1).
Using multivariate logistic regression analysis, major predictors of cardiovascular deaths following CAP were age (AOR 1.04 95%CI (1.02-1.07), p<0.0001), prior history of cardiovascular events (2.70 (1.47-4.96), p=0.001), ICU admission during hospital admission (1.87 (1.04-3.38), p=0.04) and anaemia (0.98 (0.97-0.99), p=0.0007).
Conclusion: Hospitalisation for CAP is associated with an increased risk of cardiovascular events and mortality at 1 year.
- © 2011 ERS
