Bacterial Pneumonia Associated With Increased Risk for Future MACE

The following article is part of conference coverage from the 2018 AHA Scientific Sessions in Chicago, Illinois.The Cardiology Advisor’s staff will be reporting breaking news associated with research conducted by leading experts in cardiology. Check back for the latest news from AHA 2018.

CHICAGO — Patients with bacterial pneumonia are at higher risk for major adverse cardiovascular events (MACE) within 90 days compared with those who have viral pneumonia, according to results presented at the American Heart Association Scientific Sessions 2018, held November 10-12, in Chicago, Illinois.

The comparative risk for subsequent cardiovascular events after bacterial or viral pneumonia is not well known. Researchers, therefore, conducted a retrospective comparative analysis of MACE incidence rates 90 days after the diagnosis of either bacterial or viral pneumonia.

Investigators categorized patients based on diagnosis code or the presence of positive viral test vs positive bacterial culture. Multivariable logistic regression was used to adjust for medication use and comorbid conditions.

Of 3736 patients who were diagnosed with bacterial pneumonia, 756 individuals were diagnosed based on a positive culture test and 2980 were diagnosed based on a diagnosis code. Streptococcus pneumoniae was identified as the responsible pathogen in 91% of patients.

A total of 993 patients were diagnosed with viral pneumonia, 40% of whom were found to have influenza as the cause of their pneumonia. Investigators noted that 1% of patients were diagnosed with both viral and bacterial pneumonia. Researchers found that a major cardiovascular event occurred in 32% of patients within 90 days of pneumonia diagnosis.

A major cardiovascular event occurred in 1531 patients. Significantly, a diagnosis of bacterial pneumonia was made in 82% of those who had a major cardiovascular event, whereas only 17% of those with pneumonia of viral etiology had a major cardiovascular event.

In addition, researchers found an increased risk for MACE development in those with the comorbid conditions of coronary artery disease, myocardial infarction, heart failure, dysrhythmia, hypertension, hyperlipidemia, and renal failure, diabetes, and chronic obstructive pulmonary disease 90 days after the diagnosis of pneumonia.

The use of corticosteroids, beta-blockers, statins, and calcium channel blocker medications resulted in a similar increased risk (all P <.0001).

Researchers concluded that “MACE outcomes within 90 days amount patients hospitalized with pneumonia, and the adjusted risk of 90-day major cardiovascular adverse events is 60% higher in those diagnosed with bacterial compared with viral pneumonia.”

This highlights the need for prevention of pneumonia, especially in those with comorbid conditions and/or medication use that increases the risk for cardiovascular complications.

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Reference

Steiner GS, Knight S, Miller RR III, et al. Bacterial pneumonia compared to viral pneumonia is associated with a higher risk of future major adverse cardiovascular events. Presented at: American Heart Association Scientific Sessions 2018; November 10-12, 2018; Chicago, IL.