03607nas a2200433 4500008004100000022001400041245010100055210006900156260001600225300001100241490000800252520240100260653000902661653002002670653002802690653001902718653001602737653001102753653002002764653001102784653000902795653001602804653001402820653001702834100003202851700002302883700002302906700002002929700002302949700002502972700001702997700001703014700002103031700002403052700001903076700002403095700001803119856003603137 2015 eng d a1538-359800aAssociation between hospitalization for pneumonia and subsequent risk of cardiovascular disease.0 aAssociation between hospitalization for pneumonia and subsequent c2015 Jan 20 a264-740 v3133 a

IMPORTANCE: The risk of cardiovascular disease (CVD) after infection is poorly understood.

OBJECTIVE: To determine whether hospitalization for pneumonia is associated with an increased short-term and long-term risk of CVD.

DESIGN, SETTINGS, AND PARTICIPANTS: We examined 2 community-based cohorts: the Cardiovascular Health Study (CHS, n = 5888; enrollment age, ≥65 years; enrollment period, 1989-1994) and the Atherosclerosis Risk in Communities study (ARIC, n = 15,792; enrollment age, 45-64 years; enrollment period, 1987-1989). Participants were followed up through December 31, 2010. We matched each participant hospitalized with pneumonia to 2 controls. Pneumonia cases and controls were followed for occurrence of CVD over 10 years after matching. We estimated hazard ratios (HRs) for CVD at different time intervals, adjusting for demographics, CVD risk factors, subclinical CVD, comorbidities, and functional status.

EXPOSURES: Hospitalization for pneumonia.

MAIN OUTCOMES AND MEASURES: Incident CVD (myocardial infarction, stroke, and fatal coronary heart disease).

RESULTS: Of 591 pneumonia cases in CHS, 206 had CVD events over 10 years after pneumonia hospitalization. CVD risk after pneumonia was highest in the first year. CVD occurred in 54 cases and 6 controls in the first 30 days (HR, 4.07; 95% CI, 2.86-5.27); 11 cases and 9 controls between 31 and 90 days (HR, 2.94; 95% CI, 2.18-3.70); and 22 cases and 55 controls between 91 days and 1 year (HR, 2.10; 95% CI, 1.59-2.60). Additional CVD risk remained elevated into the tenth year, when 4 cases and 12 controls developed CVD (HR, 1.86; 95% CI, 1.18-2.55). In ARIC, of 680 pneumonia cases, 112 had CVD over 10 years after hospitalization. CVD occurred in 4 cases and 3 controls in the first 30 days (HR, 2.38; 95% CI, 1.12-3.63); 4 cases and 0 controls between 31 and 90 days (HR, 2.40; 95% CI, 1.23-3.47); 11 cases and 8 controls between 91 days and 1 year (HR, 2.19; 95% CI, 1.20-3.19); and 8 cases and 7 controls during the second year (HR, 1.88; 95% CI, 1.10-2.66). After the second year, the HRs were no longer statistically significant.

CONCLUSIONS AND RELEVANCE: Hospitalization for pneumonia was associated with increased short-term and long-term risk of CVD, suggesting that pneumonia may be a risk factor for CVD.

10aAged10aAtherosclerosis10aCardiovascular Diseases10aCohort Studies10aComorbidity10aFemale10aHospitalization10aHumans10aMale10aMiddle Aged10aPneumonia10aRisk Factors1 aCorrales-Medina, Vicente, F1 aAlvarez, Karina, N1 aWeissfeld, Lisa, A1 aAngus, Derek, C1 aChirinos, Julio, A1 aChang, Chung-Chou, H1 aNewman, Anne1 aLoehr, Laura1 aFolsom, Aaron, R1 aElkind, Mitchell, S1 aLyles, Mary, F1 aKronmal, Richard, A1 aYende, Sachin uhttps://chs-nhlbi.org/node/6669