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Acute cardiovascular events in patients with community acquired pneumonia: results from the observational prospective FADOI-ICECAP study

2021; BioMed Central; Volume: 21; Issue: 1 Linguagem: Inglês

10.1186/s12879-021-05781-w

1471-2334

Filippo Pieralli, Vieri Vannucchi, Carlo Nozzoli, Giuseppe Augello, Francesco Dentali, Giulia De Marzi, Generoso Uomo, Filippo Risaliti, Laura Morbidoni, Antonino Mazzone, Claudio Santini, Daniela Tirotta, Francesco Corradi, Riccardo Gerloni, Paola Gnerre, Gualberto Gussoni, Antonella Valerio, Mauro Campanini, Dario Manfellotto, Andrea Fontanella, Tiziana Marcella Attardo, Giuseppe Augello, Francesco Dentali, L. Tavecchia, V. Gessi, Filippo Pieralli, Giulia De Marzi, Arianna Torrigiani, Lucille Corbo, Generoso Uomo, Fernando Gallucci, C. Mastrobuoni, Filippo Risaliti, Alessandra Giani, Laura Morbidoni, Consalvo Teodora, Antonino Mazzone, Elisabetta Ricchiuti, C. Santini, Antonio Rosato, Daniela Tirotta, Lidia Giampaolo, Francesco Corradi, Arianna Torrigiani, Silvana Di Gregorio, Riccardo Gerloni, Luca Parodi, Paola Gnerre, Vieri Vannucchi, Francesca Pallini, Giancarlo Landini, Pietro Paolo Giuri, Greta Prampolini, Dimitriy Arioli, Maria Comasia Leone, Claudio Canale, Francesca Condemi, Rosaria Lupica, F. Manzola, R. Mascianà, Giancarlo Agnelli, Cecilia Becattini, Erika D'Agostini, Maria Giulia Mosconi, Giulio Bogliari, Andrea Rossi, M. Campanini, G. Iannantuoni, L. Bartolino, A Montagnani, Valerio Verdiani, Maurizia Gambacorta, Salvatore Lenti, S Francioni, Matteo Giorgi‐Pierfranceschi, C. Cattabiani, Francesco Orlandini, L. Scuotri, Micaela La Regina, F Corsini, Luigi Anastasio, Nicola Mumoli, Valeria Mazzi, Alberto Camaiti, G C Balbi, Fabio Ragazzo, Martino F. Pengo,

Emergency and Acute Care Studies

Abstract Background The burden of cardiovascular (CV) complications in patients hospitalised for community-acquired pneumonia (CAP) is still uncertain. Available studies used different designs and different criteria to define CV complications. We assessed the cumulative incidence of acute of CV complications during hospitalisation for CAP in Internal Medicine Units (IMUs). Methods This was a prospective study carried out in 26 IMUs, enrolling patients consecutively hospitalised for CAP. Defined CV complications were: newly diagnosed heart failure, acute coronary syndrome, new onset of supraventricular or ventricular arrhythmias, new onset hemorrhagic or ischemic stroke or transient ischemic attack. Outcome measures were: in-hospital and 30-day mortality, length of hospital stay and rate of 30-day re-hospitalisation. Results A total of 1266 patients were enrolled, of these 23.8% experienced at least a CV event, the majority (15.5%) represented by newly diagnosed decompensated heart failure, and 75% occurring within 3 days. Female gender, a history of CV disease, and more severe pneumonia were predictors of CV events. In-hospital (12.2% vs 4.7%, p < 0.0001) and 30-day (16.3% vs 8.9%, p = 0.0001) mortality was higher in patients with CV events, as well as the re-hospitalisation rate (13.3% vs 9.3%, p = 0.002), and mean hospital stay was 11.4 ± 6.9 vs 9.5 ± 5.6 days (p < 0.0001). The occurrence of CV events during hospitalisation significantly increased the risk of 30-day mortality (HR 1.69, 95% CI 1.14–2.51; p = 0.009). Conclusion Cardiovascular events are frequent in CAP, and their occurrence adversely affects outcome. A strict monitoring might be useful to intercept in-hospital CV complications for those patients with higher risk profile. Trial registration NCT03798457 Registered 10 January 2019 - Retrospectively registered