Abstract
Background: Numerous studies have identified that patients with community-acquired pneumonia (CAP) are at higher risk of developing acute coronary syndrome (ACS). We aimed to summarise the current literature to quantify the incidence of acute coronary syndrome in adults with CAP.
Methods: We systematically searched MEDLINE and Embase, from inception to December 2018, to identify cohort and case-control studies in all languages. The inclusion criteria was adults with pneumonia, based on either clinico-radiological diagnosis or ICD codes. Patients with hospital-acquired pneumonia were excluded. Study quality was assessed by modified Newcastle Ottawa Scale. Pooled proportions were estimated using a random-effects model.
Results: Of 10,626 studies identified for title and abstract screening, 103 studies met the inclusion criteria. 26 studies were included in the systematic review following full-text review (n=66,347 patients). Most of the included studies were of good quality; median quality score across the cohort studies was 5 out of 5 (IQR 4-5). Meta-analysis showed that the pooled incidence of ACS in-hospital and 30 days after CAP were 3.2% (95% CI 2.4-4.0%; n=17 studies) and 3.5% (95% CI 2.8-4.2%; n=25 studies) respectively. Sensitivity analysis excluding studies with selected cohorts (elderly, predominantly male or ICU admissions only) showed a higher pooled incidence for in-hospital ACS (4%, 95% CI 2.7-5.3%, n=13 studies) but unchanged for 30-day incidence.
Conclusion: This meta-analysis highlights a small but important risk of ACS in patients with CAP; the in-hospital incidence of ACS was 3.2% and 30-day incidence was 3.5%.
Footnotes
Cite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 1778.
This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2020