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Cardiac diseases complicating community-acquired pneumonia

Aliberti, Stefanoa; Ramirez, Julio A.b

Current Opinion in Infectious Diseases: June 2014 - Volume 27 - Issue 3 - p 295–301
doi: 10.1097/QCO.0000000000000055
Edited by Michael S. Niederman

Purpose of review The aim is to evaluate basic mechanisms, prevalence, risk factors, outcomes, and potential treatments of cardiovascular events (CVEs) in patients with community-acquired pneumonia (CAP).

Recent findings In this review, we present a new model to evaluate the pathophysiology of cardiac disease in patients with pneumonia based on plaque-related events, such as acute myocardial infarction, versus plaque-unrelated events, such as arrhythmias and heart failure. CAP increases the risk for both plaque-related and plaque-unrelated events with an absolute rate of CVE across different cohorts that varies broadly from 10 to 30%. These complications may happen among both ambulatory patients and inpatients, either on admission or during hospitalization, and/or after discharge. CVEs represent a major cause for increased mortality in CAP patients, contributing to more than 30% of deaths at long-term follow-up.

Summary From a clinical perspective, especially during the first 24 h after hospitalization, CAP patients should be tested for the probability to have or develop during hospitalization a cardiac event. From a research point of view, there is an urgent need to prospectively evaluate cardioprotective interventions.

aDepartment of Health Science, University of Milan-Bicocca, Respiratory Dept, AO San Gerardo, Monza, Italy

bChief, Division of Infectious Diseases and Professor of Medicine, Department of Medicine, University of Louisville, Louisville, Kentucky, USA

Correspondence to Julio A. Ramirez, MD, Chief, Division of Infectious Diseases and Professor of Medicine, Department of Medicine, University of Louisville, 501 E. Broadway, Suite 120, Louisville, Kentucky 40202, USA. Tel: +1 502 852 7844; e-mail: j.ramirez@louisville.edu

© 2014 Lippincott Williams & Wilkins, Inc.