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An increased risk of cardiovascular events (CVEs) in hospitalized patients with community-acquired pneumonia (CAP) was recently reported.
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CVEs may be the primary determinant of clinical failure in hospitalized patients with CAP.
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Therapeutics beyond antibiotics (eg, heparin or aspirin) may be indicated during and after hospitalization.
What is the Association of Cardiovascular Events with Clinical Failure in Patients with Community-Acquired Pneumonia?
Section snippets
Key points
Definitions of clinical failure and CVEs
Different criteria have been used by different investigators to define the presence of clinical failure in hospitalized patients with CAP.6 Using a pathophysiologic approach, clinical failure can be characterized as being related to either CAP or the management of CAP (Fig. 1).7 Clinical failure related to CAP is explained by the pathophysiology of the pulmonary infection with its associated local and systemic inflammatory response. Clinical failure related to CAP may develop from the
CVEs and clinical failure within 30 days’ follow-up
Most studies evaluating the association between CVEs and CAP have evaluated patients during hospitalization. Some of these studies evaluated the incidence of CVEs during hospitalization for CAP, whereas others also included the association between CVEs and clinical outcomes. Of these, only one study reported data on clinical failure.7
In a retrospective cohort study of 170 consecutive patients hospitalized for pneumococcal pneumonia, almost 20% developed CVEs, which included AMI, serious
CVEs and clinical failure at long-term follow-up
Although several articles reported increased long-term mortality in hospitalized patients with CAP,14, 15 CVEs were only recently implicated as one of the possible explanations for this increased mortality.11, 16, 17, 18 In a study designed to understanding mechanisms and predictors of increased long-term mortality, the authors evaluated the association between serum markers of inflammation and mortality within the first year after an episode of pneumonia.16 This study reported CVE as the first
Summary
Increased incidence of CVEs associated with increased clinical failure and mortality rates has been documented in hospitalized patients with CAP.
Investigators have hypothesized that the increased risk of CVEs in this population is partly from atherosclerotic plaque instability related to the systemic inflammation from the pneumonia. This close relationship between CAP and CVEs is further evidenced by the seasonality of both processes and the reduction of CVEs seen after vaccination for
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Early and Late Cardiovascular Events in Patients Hospitalized for Community-Acquired Pneumonia
2020, Archivos de BronconeumologiaThe management of community-acquired pneumonia in the elderly
2014, European Journal of Internal MedicineCitation Excerpt :The most common causes of clinical failure were severe sepsis, myocardial infarction (MI), progressive pneumonia and HAP [67]. Several authors have recently reported an increased risk of cardiovascular events in hospitalized patients with CAP [68,69]. A meta-analysis by Corrales-Medina et al. highlighted how common cardiovascular events are among patients with pneumonia, with an overall cardiac events rate of 18% in the 17 studies evaluated [70].
Drug Repositioning with GraphSAGE and Clustering Constraints Based on Drug and Disease Networks
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