The influence of community-acquired pneumonia on the clinical course of coronary heart disease: the results of retrospective analysis
DOI:
https://doi.org/10.15587/2519-4798.2017.116826Keywords:
coronary heart disease, community-acquired pneumonia, cardio-vascular event, mortality, risk factorsAbstract
The aim of the work: To investigate the effect of the community-acquired pneumonia (CAP) on the clinical course of coronary heart disease (CHD) and the frequency of major cardiovascular events incidence based on the retrospective analysis results.
Methods: The retrospective analysis of 203 case histories of patients with CHD (median age 73 years (63.00, 80.50), score on the PSI/PORT – 80 (69; 93)), hospitalized in the therapeutic department because of CAP was performed. The study of the main cardiovascular events was conducted with each patient or his relatives through telephone conversations. The data on readmission and reference of the patient to medical institutions in the consequence of arrhythmic complications, progression of heart failure, destabilization of coronary artery disease within 1 year after the transmitted pneumonia were considered. By cumulative endpoint attributed all fatal and nonfatal cardiovascular events that occurred during the year after CAP.
Results: In total, in patients with CHD during 1 year after the transferred CAP was recorded 104 cardiovascular events, 37 (18.23 %) patients needed the re-hospitalization. The most common causes of health aggravation in patients with CHD after CAP were the rhythm and conduction abnormalities, the occurrence or decompensation of pre-existing heart failure and deterioration of angina pectoris. Among the hospitalized patients, 20 (62.5 %) had a combination of 2 or more of the noted complications. The development of acute myocardial infarction was observed in 3 (1.48 %) patients at 7 and 9 days from the moment of admission for hospitalization. The arrhythmias, acute myocardial infarction and decompensation of heart failure were observed with the same frequency in patients of all groups, regardless of the severity of pneumonia and the risk of mortality on the PSI/PORT scale. There were not found the impact on the development of adverse cardiovascular events in patients with CHD after CAP such factors as male gender, presence of anamnesis of transmitted myocardial infarction, arterial hypertension, angina pectoris III-IV FK, previous arrhythmic disorders, and also such traditional factors as smoking and diabetes mellitus.
Conclusions: The community-acquired pneumonia exerts an adverse effect on the clinical course of coronary heart disease by increasing the functional class of angina, heart failure progress and the development of arrhythmic; the most common cause of the lethal outcome in patients with coronary heart disease after community-acquired pneumonia is acute heart failure (alveolar pulmonary edema).There was not found the relationship between traditional risk factors, severity of CAP and the development of adverse cardiovascular events
References
- Townsend, N., Wilson, L., Bhatnagar, P., Wickramasinghe, K., Rayner, M., Nichols, M. (2016). Cardiovascular disease in Europe: epidemiological update 2016. European Heart Journal, 37 (42), 3232–3245. doi: 10.1093/eurheartj/ehw334
- Kovalenko, V., Kornatskiy, V. (2016). Problemy zdorov'ia i medychnoi dopomogy ta model pokrashchennia v suchasnykh umovakh [The problems of health and health care and it's improuvment model in modern conditions]. Kyiv, 260.
- Lynnyck, M., Nedospasova, O., Tarasenko, O., Bushura, I., Nikiforova, L. (2016). Porivnialni dani pro rozpovsiudgenist khvorob organiv dykhannia i medychnu dopomogu khvorym na khvoroby pulmonologichnogo ta alergologichnogo profiliu v Ukraini za 2009–2015 rr. [Comparative data on the prevalence of respiratory diseases and medical care for patients with pulmonary and allergy profile diseases in Ukraine for 2009–2015 years]. Kyiv: Lira-K, 48.
- Corrales-Medina, V. F., Musher, D. M., Wells, G. A., Chirinos, J. A., Chen, L., Fine, M. J. (2012). Cardiac Complications in Patients With Community-Acquired Pneumonia: Incidence, Timing, Risk Factors, and Association With Short-Term Mortality. Circulation, 125 (6), 773–781. doi: 10.1161/circulationaha.111.040766
- Perry, T. W., Pugh, M. J. V., Waterer, G. W., Nakashima, B., Orihuela, C. J., Copeland, L. A. et. al. (2011). Incidence of Cardiovascular Events After Hospital Admission for Pneumonia. The American Journal of Medicine, 124 (3), 244–251. doi: 10.1016/j.amjmed.2010.11.014
- Mandal, P., Chalmers, J. D., Choudhury, G., Akram, A. R., Hill, A. T. (2011). Vascular complications are associated with poor outcome in community-acquired pneumonia. QJM, 104 (6), 489–495. doi: 10.1093/qjmed/hcq247
- Musher, D. M., Rueda, A. M., Kaka, A. S., Mapara, S. M. (2007). The Association between Pneumococcal Pneumonia and Acute Cardiac Events. Clinical Infectious Diseases, 45 (2), 158–165. doi: 10.1086/518849
- Viasus, D., Garcia-Vidal, C., Manresa, F., Dorca, J., Gudiol, F., Carratalà, J. (2013). Risk stratification and prognosis of acute cardiac events in hospitalized adults with community-acquired pneumonia. Journal of Infection, 66 (1), 27–33. doi: 10.1016/j.jinf.2012.09.003
- Griffin, A. T., Wiemken, T. L., Arnold, F. W. (2013). Risk factors for cardiovascular events in hospitalized patients with community-acquired pneumonia. International Journal of Infectious Diseases, 17 (12), e1125–e1129. doi: 10.1016/j.ijid.2013.07.005
- Ramirez, J., Aliberti, S., Mirsaeidi, M., Peyrani, P., Filardo, G., Amir, A. et. al. (2008). Acute Myocardial Infarction in Hospitalized Patients with Community‐Acquired Pneumonia. Clinical Infectious Diseases, 47 (2), 182–187. doi: 10.1086/589246
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2017 Tamila Kulynych, Natalia Mykhailovska
This work is licensed under a Creative Commons Attribution 4.0 International License.
Our journal abides by the Creative Commons CC BY copyright rights and permissions for open access journals.
Authors, who are published in this journal, agree to the following conditions:
1. The authors reserve the right to authorship of the work and pass the first publication right of this work to the journal under the terms of a Creative Commons CC BY, which allows others to freely distribute the published research with the obligatory reference to the authors of the original work and the first publication of the work in this journal.
2. The authors have the right to conclude separate supplement agreements that relate to non-exclusive work distribution in the form in which it has been published by the journal (for example, to upload the work to the online storage of the journal or publish it as part of a monograph), provided that the reference to the first publication of the work in this journal is included.
