2195. Incidence of Acute Myocardial Infarction in Patients with Community-Acquired Pneumonia: A Systematic Review and Meta-Analysis

Abstract

BackgroundCommunity-acquired pneumonia (CAP) is a respiratory disease that is responsible for an estimated 3.5 million worldwide deaths annually. In the last few years, it has been hypothesized that CAP is implicated in the development of diseases in other systems such as renal and cardiovascular. Until this moment, multiple studies evaluating incidence of acute myocardial infarction (AMI) in patients with CAP exist, but data are still unclear. Our objective was to summarize several studies available regarding incidence of Acute Myocardial Infarction (AMI) in patients with CAP and to compare such value with the incidence of AMI in the general population.MethodsWe conducted a systematic review of articles published between January 1980 and January 2019 in the PubMed and PubMed Central databases. Studies describing the incidence of AMI in patients with CAP were included. We extracted their diagnostic criteria for CAP and AMI, and their AMI follow-up periods. In addition to this, we calculated cumulative incidence of AMI in patients with CAP and compared such value with the general population.Results1841 studies were identified (Figure 1), of which 10 studies were included in our review (Figure 2). From a forest plot-random effects model, the cumulative incidence of AMI among patients hospitalized due to CAP was 2,440 per 100,000 (95% CI: 1,780; 3,320) (Figure 3). Using the age-adjusted incidence of 649 cases of CAP per 100,000 adults described by Ramirez et al., we estimated that 16 per 100,000 adults will have an AMI associated with CAP (95% CI: 12;22) per year in the US Moreover, Yeh et al. found that the incidence of AMI in the general population was 208 per 100,000 people, comparing this value, to the values obtained in our meta-analysis of 2,440 acute myocardial infarctions by 100, 000 people, we can infer that adult patients hospitalized due to CAP have an 11.7-fold increase from the general population for risk of MI.ConclusionA higher risk of AMI was observed among adults hospitalized with CAP compared with the general population. Results must be carefully analyzed given the heterogeneity of the studies. At a clinical level, this increase in AMI incidence in patients with CAP should be taken into account in order to give the best therapeutic management to such patients. Disclosures All authors: No reported disclosures.