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Association between hospitalization for pneumonia and subsequent risk of cardiovascular disease.
Tuesday,2015-04-07 15:11 America/Los_Angeles — zdrager
| Title | Association between hospitalization for pneumonia and subsequent risk of cardiovascular disease. |
| Publication Type | Journal Article |
| Year of Publication | 2015 |
| Authors | Corrales-Medina, VF, Alvarez, KN, Weissfeld, LA, Angus, DC, Chirinos, JA, Chang, C-CH, Newman, A, Loehr, L, Folsom, AR, Elkind, MS, Lyles, MF, Kronmal, RA, Yende, S |
| Journal | JAMA |
| Volume | 313 |
| Issue | 3 |
| Pagination | 264-74 |
| Date Published | 2015 Jan 20 |
| ISSN | 1538-3598 |
| Keywords | Aged, Atherosclerosis, Cardiovascular Diseases, Cohort Studies, Comorbidity, Female, Hospitalization, Humans, Male, Middle Aged, Pneumonia, Risk Factors |
| Abstract | <p><b>IMPORTANCE: </b>The risk of cardiovascular disease (CVD) after infection is poorly understood.</p><p><b>OBJECTIVE: </b>To determine whether hospitalization for pneumonia is associated with an increased short-term and long-term risk of CVD.</p><p><b>DESIGN, SETTINGS, AND PARTICIPANTS: </b>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.</p><p><b>EXPOSURES: </b>Hospitalization for pneumonia.</p><p><b>MAIN OUTCOMES AND MEASURES: </b>Incident CVD (myocardial infarction, stroke, and fatal coronary heart disease).</p><p><b>RESULTS: </b>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.</p><p><b>CONCLUSIONS AND RELEVANCE: </b>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.</p> |
| DOI | 10.1001/jama.2014.18229 |
| Alternate Journal | JAMA |
| PubMed ID | 25602997 |
| PubMed Central ID | PMC4687729 |
| Grant List | AG023629 / AG / NIA NIH HHS / United States HHSN268200800007C / / PHS HHS / United States HHSN268201100005C / / PHS HHS / United States HHSN268201100006C / / PHS HHS / United States HHSN268201100007C / / PHS HHS / United States HHSN268201100008C / / PHS HHS / United States HHSN268201100009C / / PHS HHS / United States HHSN268201100010C / / PHS HHS / United States HHSN268201100011C / / PHS HHS / United States HHSN268201100012C / / PHS HHS / United States HHSN268201200036C / / PHS HHS / United States HL080295 / HL / NHLBI NIH HHS / United States K23GM083215 / GM / NIGMS NIH HHS / United States N01 HC055019 / HC / NHLBI NIH HHS / United States N01 HC55222 / HC / NHLBI NIH HHS / United States N01HC85079 / HC / NHLBI NIH HHS / United States N01HC85080 / HC / NHLBI NIH HHS / United States N01HC85081 / HC / NHLBI NIH HHS / United States N01HC85082 / HC / NHLBI NIH HHS / United States N01HC85083 / HC / NHLBI NIH HHS / United States N01HC85086 / HC / NHLBI NIH HHS / United States R01 GM097471 / GM / NIGMS NIH HHS / United States R01GM097471 / GM / NIGMS NIH HHS / United States TL1 TR000145 / TR / NCATS NIH HHS / United States UL1 TR000005 / TR / NCATS NIH HHS / United States |