The association of cardioprotective medications with pneumonia-related outcomes.
BACKGROUND
Little research has examined whether cardiovascular medications, other than statins, are associated with improved outcomes after pneumonia. Our aim was to examine the association between the use of beta-blockers, statins, angiotensin converting enzyme (ACE) inhibitors, and angiotensin II receptor blockers (ARBs) with pneumonia-related outcomes.


METHODS
We conducted a retrospective population-based study on male patients ≥ 65 years of age hospitalized with pneumonia and who did not have pre-existing cardiac disease. Our primary analyses were multilevel regression models that examined the association between cardiovascular medication classes and either mortality or cardiovascular events.


RESULTS
Our cohort included 21,985 patients: 22% died within 90 days of admission, and 22% had a cardiac event within 90 days. The cardiovascular medications studied that were associated with decreased 90-day mortality included: statins (OR 0.70, 95% CI 0.63-0.77), ACE inhibitors (OR 0.82, 95% CI 0.74-0.91), and ARBs (OR 0.58, 95% CI 0.44-0.77). However, none of the medications were significantly associated with decreased cardiovascular events.


CONCLUSIONS
While statins, ACE inhibitors, and ARBs, were associated with decreased mortality, there was no significant association with decreased CV events. These results indicate that this decreased mortality is unlikely due to their potential cardioprotective effects.
Medical Service, South Texas Veterans Health Care System, San Antonio, Texas, United States of America ; Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States of America.
Albert
A
Wu
VA Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, United States of America ; Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America.
Chester
C
Good
Medical Service, South Texas Veterans Health Care System, San Antonio, Texas, United States of America ; Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States of America.
John R
JR
Downs
VA Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, United States of America ; Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America.
Michael J
MJ
Fine
Medical Service, South Texas Veterans Health Care System, San Antonio, Texas, United States of America ; Departments of Epidemiology and Biostatistics, University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States of America.
Mary Jo V
MJ
Pugh
Medical Service, South Texas Veterans Health Care System, San Antonio, Texas, United States of America ; Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States of America.
Antonio
A
Anzueto
Medical Service, VA North Texas Health Care System, Dallas, Texas, United States of America ; Departments of Internal Medicine and Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, United States of America.
Eric M
EM
Mortensen
D000368:Aged; D000369:Aged, 80 and over; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D008297:Male; D011014:Pneumonia / Q000150:complications* / Q000188:drug therapy; D012189:Retrospective Studies; D016896:Treatment Outcome
D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors