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Vascular events following hospitalisation for community acquired pneumonia

Ahsan R. Akram, James D. Chalmers, Aran Singanayagam, Gillian B. Fleming, Joanne K. Taylor, Duncan Mills, Adam T. Hill
European Respiratory Journal 2011 38: p2480; DOI:
Ahsan R. Akram
1Department of Respiratory Medicine, New Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
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James D. Chalmers
1Department of Respiratory Medicine, New Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
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Aran Singanayagam
1Department of Respiratory Medicine, New Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
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Gillian B. Fleming
2College of Medicine, University of Edinburgh, Edinburgh, United Kingdom
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Joanne K. Taylor
2College of Medicine, University of Edinburgh, Edinburgh, United Kingdom
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Duncan Mills
2College of Medicine, University of Edinburgh, Edinburgh, United Kingdom
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Adam T. Hill
1Department of Respiratory Medicine, New Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
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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).

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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
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Vascular events following hospitalisation for community acquired pneumonia
Ahsan R. Akram, James D. Chalmers, Aran Singanayagam, Gillian B. Fleming, Joanne K. Taylor, Duncan Mills, Adam T. Hill
European Respiratory Journal Sep 2011, 38 (Suppl 55) p2480;

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Vascular events following hospitalisation for community acquired pneumonia
Ahsan R. Akram, James D. Chalmers, Aran Singanayagam, Gillian B. Fleming, Joanne K. Taylor, Duncan Mills, Adam T. Hill
European Respiratory Journal Sep 2011, 38 (Suppl 55) p2480;
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