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