ICAAC-IDSA: Pneumonia Linked to Acute Coronary Syndrome

WASHINGTON, 02 nov 2008-- Patients hospitalized with bacterial pneumonia have about eight times the risk of acute coronary syndrome as those admitted for other causes, a researcher said here.
The risk is highest within 15 days of admission, said Vicente Corrales-Medina, M.D., of Baylor College of Medicine in Houston.
The association -- found in a retrospective case-control analysis -- is "so striking" it suggested a causal relationship, Dr. Corrales-Medina said at the Interscience Conference on Antimicrobial Agents and Chemotherapy, held jointly with the Infectious Diseases Society of America meeting.
"There is evidence that suggests that acute infections -- not just pneumonia -- can cause acute changes in atherosclerotic plaques," Dr. Corrals-Medina said.
Such changes, combined with effects of pneumonia such as respiratory stress, might lead to acute coronary syndromes, including unstable angina or myocardial infarction, he said.
Dr. Corrales-Medina and colleagues analyzed the records of 206 patients admitted to the Michael E. DeBakey VA Medical Center in Houston with a clinical, radiological, and bacteriological diagnosis of pneumonia from January 2000 through December 2006.
Of those cases, 144 were caused by Streptococcus pneumoniae and 62 by Haemophilus influenzae, Dr. Corrales-Medina said.
For a control group, the researchers identified 395 patients admitted with a diagnosis that was neither pneumonia nor acute coronary syndrome, who were matched by date and time of admission.
When the two groups were compared, 22 of the pneumonia patients (10.7%) had acute coronary syndrome within 15 days of admission, compared with six (1.5%) of the controls, Dr. Corrales-Medina said.
In a univariate analysis, he said, the odds ratio was 7.8, with a 95% confidence interval from 3.1 to 19.4, which was significant at P<0.001.>