Cilli A, et al. - In patients with severe community-acquired pneumonia (CAP), researchers determined the prevalence, characteristics, risk factors and influence on mortality of acute cardiac events. A considerable percentage of patients with severe CAP suffered acute cardiac events. The occurrence of these acute cardiac events was found to be significantly related to in-hospital mortality.

Methods

• In this multicenter, retrospective cohort study of patients with severe CAP, predictors for acute cardiac events and mortality were determined using a logistic regression analysis.
• Cardiac events were defined as cardiac arrhythmia, congestive heart failure and myocardial infarction.

Results

• A total of 373 patients (mean age 68 ± 16, 61.4% male) were included.
• Of those, 56 (15%) experienced a cardiac event (43 arrhythmia, 11 congestive heart failure, and 2 myocardial infarction).
• The following features were noted in patients who developed an acute cardiac event: older, more severe disease, pleural effusion, hypoalbuminemia, hyponatremia and more acidosis.
• Also, these patients had more significant use of beta-blockers and diuretics.
• Patients who developed cardiac events had significantly higher in-hospital mortality (29.6% vs 11%, P < .001).
• Acute cardiac events were predicted by haloperidol, vasopressor or diuretic use, hypoalbuminemia and age, as shown in the logistic regression analysis.
• A significant association of acute cardiac events with in-hospital mortality (OR 2.1; 95%CI 1.03-4.61, P=.04), but not with 90-day mortality, was noted.