title: Cardiovascular Complications and Short-term Mortality Risk in Community-Acquired Pneumonia.
abstract: Previous reports suggest that community-acquired pneumonia (CAP) is associated with an enhanced risk of cardiovascular complications. However, a contemporary and comprehensive characterization of this association is lacking.
  In this multicenter study, 1182 patients hospitalized for CAP were prospectively followed for up to 30 days after their hospitalization for this infection. Study endpoints included myocardial infarction, new or worsening heart failure, atrial fibrillation, stroke, deep venous thrombosis, cardiovascular death, and total mortality.
  Three hundred eighty (32.2%) patients experienced intrahospital cardiovascular events (CVEs) including 281 (23.8%) with heart failure, 109 (9.2%) with atrial fibrillation, 89 (8%) with myocardial infarction, 11 (0.9%) with ischemic stroke, and 1 (0.1%) with deep venous thrombosis; 28 patients (2.4%) died for cardiovascular causes. Multivariable Cox regression analysis showed that intrahospital Pneumonia Severity Index (PSI) class (hazard ratio [HR], 2.45, P = .027; HR, 4.23, P < .001; HR, 5.96, P < .001, for classes III, IV, and V vs II, respectively), age (HR, 1.02, P = .001), and preexisting heart failure (HR, 1.85, P < .001) independently predicted CVEs. One hundred three (8.7%) patients died by day 30 postadmission. Thirty-day mortality was significantly higher in patients who developed CVEs compared with those who did not (17.6% vs 4.5%, P < .001). Multivariable Cox regression analysis showed that intrahospital CVEs (HR, 5.49, P < .001) independently predicted 30-day mortality (after adjustment for age, PSI score, and preexisting comorbid conditions).
  CVEs, mainly those confined to the heart, complicate the course of almost one-third of patients hospitalized for CAP. More importantly, the occurrence of CVEs is associated with a 5-fold increase in CAP-associated 30-day mortality.
authors.affiliation: Department of Internal Medicine and Medical Specialties.
authors.forename: Francesco
authors.initials: F
authors.lastname: Violi
authors.affiliation: Department of Internal Medicine and Medical Specialties.
authors.forename: Roberto
authors.initials: R
authors.lastname: Cangemi
authors.affiliation: Department of Public Health and Infectious Diseases, and.
authors.forename: Marco
authors.initials: M
authors.lastname: Falcone
authors.affiliation: Infectious and Tropical Diseases Unit, Department of Clinical Medicine, Sapienza University of Rome, and.
authors.forename: Gloria
authors.initials: G
authors.lastname: Taliani
authors.affiliation: Internal and Emergency Medicine Unit, Careggi University Hospital, Florence, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Pieralli
authors.affiliation: Internal and Emergency Medicine Unit, Careggi University Hospital, Florence, Italy.
authors.forename: Vieri
authors.initials: V
authors.lastname: Vannucchi
authors.affiliation: Internal and Emergency Medicine Unit, Careggi University Hospital, Florence, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Nozzoli
authors.affiliation: Department of Public Health and Infectious Diseases, and.
authors.forename: Mario
authors.initials: M
authors.lastname: Venditti
authors.affiliation: Division of Cardiology, University of Pennsylvania, Philadelphia.
authors.forename: Julio A
authors.initials: JA
authors.lastname: Chirinos
authors.affiliation: Department of Medicine, University of Ottawa, and.|Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ontario, Canada.
authors.forename: Vicente F
authors.initials: VF
authors.lastname: Corrales-Medina
mesh_terms: D000368:Aged; D001145:Arrhythmias, Cardiac / Q000453:epidemiology / Q000401:mortality; D002318:Cardiovascular Diseases / Q000150:complications* / Q000401:mortality; D015331:Cohort Studies; D017714:Community-Acquired Infections / Q000150:complications* / Q000453:epidemiology / Q000401:mortality*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000401:mortality; D011014:Pneumonia / Q000150:complications / Q000453:epidemiology / Q000401:mortality*; D016016:Proportional Hazards Models; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology / Q000401:mortality
keywords: cardiovascular events; mortality.; pneumonia