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Arquivos de Medicina

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Community Acquired Pneumonia (CAP), Type 2 Myocardial Infarction (Type 2 MI), and 5 Years Mortality after Discharge

Arnon Blum, Liat Azani

Background: Epidemiologic studies demonstrated that community acquired pneumonia is associated with increased risk for cardiovascular events. Type 2 MI has been shown to predict a grave outcome, but the long term outcome of patients admitted with CAP who had also type 2 MI has not been studied.

Methods: during the years 2010-2016 all patients that were admitted with CAP were included in this retrospective study, and parameters like type 2 MI, age, gender, type 2 diabetes mellitus and renal failure were collected. The 5 years post discharge mortality rate was analyzed in relation with the clinical parameters.

Results: A total of 1751 consecutive patients were studied, 1222 died during the 5 years follow-up. Type 2 MI during hospitalization with CAP was associated with a higher mortality rate during the follow-up period (38.6% vs. 26.8%). Mortality rate was also dependent on older age and on renal failure.

Regression logistic analysis demonstrated an odds ratio of 19.90 to die after discharge for patients admitted with CAP who developed type 2 MI on admission or during hospitalization, and an odds ratio of 2.054 to die in CAP patients who suffered from renal failure.

Conclusions: Type 2 MI predicted a higher mortality rate during the 5 years follow up post discharge with odds ratio of 19.90. We recommend to modify the risk stratification of patients admitted with CAP and to consider type 2 MI as a risk factor for a long term outcome of patients admitted with CAP, especially older patients and those who suffer from renal failure.