Biomarkers and cardiovascular events in community-acquired pneumonia

Abstract

Introduction: Community-acquired pneumonia (CAP) increases the risk of cardiovascular (CV) events. Aim: To study the occurrence of CV events in patients with CAP and their link with biomarkers. Method: Prospective study in a Spanish hospital in 572 patients with CAP followed for 1 year. We collected comorbidities, CV events (from admission to 1 year) and biomarkers: proBNP, troponins (TnT), endothelin, proadrenomedullin (proADM), procalcitonin (PCT). We performed ROC curve of biomarkers for CV events. Results: We studied 322 patients with biomarkers; 65 (20.2%) had CV events (39 after discharge). Biomarkers are shown in table1. The areas under the ROC curve (AUC) of biomarkers day 1 for CV events: TnT 0.77(95%CI 0.71-0.84), proBNP 0.77(0.70-0.84), endothelin 0.70(0.61-0.80), proADM 0.70(0.60-0.79), PCT 0.56(0.46-0.66). The AUC of day 4: proADM 0.77(0.70-0.85), endothelin 0.75(0.67-0.83), proBNP 0.75(0.67-0.82), TnT 0.75(0.68-0.82), PCT 0.56(0.47-0.66). Conclusions: Biomarkers may predict early and long-term CV events in CAP. TnT and proBNP during the 1st day and proADM the 4th day are the best biomarkers predicting CV events. | | No cardiovascular events | Cardiovascular events | P value | || | ProADM day 1 | 0.9 (0.7-1.2) | 1.5 (1.0-2.1) | 0.000 | | ProADM day 4 | 0.8 (0.6-0.9) | 1.2 (0.9-1.6) | 0.000 | | PCT day 1 | 0.3 (0.1-1.7) | 0.7 (0.2-3.4) | 0.035 | | PCT day 4 | 0.1 (0.0-0.4) | 0.2 (0.1-0.5) | 0.123 | | Endothelin day 1 | 79.4 (54.7-117.9) | 143.3 (96.6-188.9) | 0.000 | | Endothelin day 4 | 62.4 (47.0-79.7) | 93.5 (78.4-129.7) | 0.000 | | TnT day 1 | 11.1 (4.3-21.6) | 28.1 (15.9-47.8) | 0.000 | | TnT day 4 | 10.3 (4.7-21.3) | 23.2 (15.8-50.0) | 0.000 | | ProBNP day 1 | 553.9 (177.6-1559.0) | 2465.0 (1006.0-6523.0) | 0.000 | | ProBNP day 4 | 385.5 (113.5-1405.0) | 2059.0 (681.7-3926.0) | 0.000 | * Data presented as median (Q1-Q3) Cardiovascular and inflammatory biomarkers