title: Pneumonia and inflammation in acute decompensated heart failure: a registry-based analysis of 1939 patients.
abstract: BACKGROUND
  The prognostic impact of pneumonia and signs of systemic inflammation in patients with acute decompensated heart failure (ADHF) has not been fully elucidated yet. The aim of the present study was thus to investigate the association of pneumonia and the inflammation surrogate C-reactive protein with all-cause mortality in patients admitted for ADHF.
  
  
  METHODS
  We analysed data of 1939 patients admitted for ADHF. Patients were dichotomised according to the presence or absence of pneumonia. The primary endpoint of all-cause mortality was determined by death registry linkage.
  
  
  RESULTS
  In total, 412 (21.2%) patients had concomitant pneumonia. Median C-reactive protein levels were higher in patients with compared to patients without pneumonia (24.9 versus 9.8 mg/l, respectively; P<0.001). All-cause mortality was significantly higher in patients with pneumonia ( P<0.001). In adjusted Cox regression models, pneumonia as well as C-reactive protein were independently associated with in-hospital mortality. Only C-reactive protein remained as independent predictor for long-term mortality.
  
  
  CONCLUSIONS
  Pneumonia is relatively common in ADHF and a predictor for in-hospital mortality. However, inflammation in general seems to be more important than pneumonia itself for long-term prognosis. Compared to community-acquired pneumonia studies, C-reactive protein levels were rather low and therefore pneumonia might be over-diagnosed in ADHF patients.
authors.affiliation: 1 University Heart Center Lübeck, Department of Cardiology, Angiology and Intensive Care Medicine, Germany.|2 German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Jobs
authors.affiliation: 1 University Heart Center Lübeck, Department of Cardiology, Angiology and Intensive Care Medicine, Germany.
authors.forename: Ronja
authors.initials: R
authors.lastname: Simon
authors.affiliation: 1 University Heart Center Lübeck, Department of Cardiology, Angiology and Intensive Care Medicine, Germany.|2 German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Germany.
authors.forename: Suzanne
authors.initials: S
authors.lastname: de Waha
authors.affiliation: 1 University Heart Center Lübeck, Department of Cardiology, Angiology and Intensive Care Medicine, Germany.|2 German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Germany.
authors.forename: Kyrill
authors.initials: K
authors.lastname: Rogacev
authors.affiliation: 3 Institute for Cancer Epidemiology eV, University of Lübeck, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Katalinic
authors.affiliation: 3 Institute for Cancer Epidemiology eV, University of Lübeck, Germany.
authors.forename: Valentin
authors.initials: V
authors.lastname: Babaev
authors.affiliation: 1 University Heart Center Lübeck, Department of Cardiology, Angiology and Intensive Care Medicine, Germany.|2 German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Germany.
authors.forename: Holger
authors.initials: H
authors.lastname: Thiele
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D002423:Cause of Death / Q000639:trends; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006333:Heart Failure / Q000097:blood / Q000150:complications* / Q000401:mortality; D006801:Humans; D015994:Incidence; D007249:Inflammation / Q000097:blood / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D011014:Pneumonia / Q000097:blood / Q000453:epidemiology / Q000209:etiology*; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein
keywords: Acute decompensated heart failure; C-reactive protein; inflammation; pneumonia; prognosis