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Cardiac biomarkers pinpoint CAP patients at high risk of adverse CV events

20 Aug 2019

Cardiac biomarkers are useful for identifying community-acquired pneumonia (CAP) patients with an elevated risk of early and long-term cardiovascular (CV) events, according to a study.

Researchers followed 730 hospitalized CAP patients for 1 year. They measured several cardiovascular (proadrenomedullin [proADM], pro b-type natriuretic peptide [proBNP], proendothelin-1, and troponin T) and inflammatory biomarkers (interleukin 6 [IL-6], C-reactive protein [CRP] and procalcitonin [PCT]) at several time points (days 1, 4/5 and 30), exploring their utility for assessing early (within 30 days) or long-term (1 year follow-up) CV events.

A total of 92 patients developed an early CV event and 67 a long-term event. Patients who did vs did not develop CV events had markedly higher initial levels of proADM, proendothelin-1, troponin, proBNP and IL-6. Despite a drop at day 4/5, levels remained quite steady until day 30 in those who developed late events.

On multivariable regression analysis, several days 1 and 30 biomarkers independently predicted CV events, as follows: proendothelin-1 (odds ratio [OR], 2.25, 95 percent CI, 1.34–3.79), proADM (OR, 2.53, 1.53–4.20), proBNP (OR, 2.67, 1.59–4.49) and troponin T (OR, 2.70, 1.62–4.49) for early events, and proendothelin-1 (OR, 3.13, 1.41–7.80), proADM (OR, 2.29, 1.01–5.19) and proBNP (OR, 2.34, 1.01–5.56) for late events.

Furthermore, the addition of IL-6 levels at day 30 to proendothelin-1 or proADM strengthened these cardiac biomarkers’ association with late CV events (ORs, 3.53 and 2.80, respectively).

The findings highlight the usefulness of cardiac biomarkers, potentially aiding personalized treatment optimization and facilitating design of future interventional studies to reduce CV risk, the researchers said.

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Most Read Articles
Pearl Toh, 24 Oct 2019
Using e-cigarettes can lead to cellular inflammation in the lungs among healthy adults who had never smoked, even with use as short as 4 weeks, suggests a pilot study.
24 Feb 2019
Dr Ong Kian Chung, a respiratory specialist at the KC Ong Chest & Medical Clinic, Mount Elizabeth Medical Centre, Singapore spoke on the evils of tobacco use and how clinicians can help in smoking cessation.
01 Nov 2018
The prevalence of allergic diseases in the Asia-Pacific region is expected to rise over the next 20 years, driven by rapid economic development and urbanization. Allergic diseases have high socioeconomic impact by impairing productivity and quality of life, and the impact may be greater in Asia-Pacific than in Europe due to the presence and predominance of perennial allergens.