A Multicentric Observational Study to Determine Myocardial Injury in Severe Community-Acquired Pneumonia (sCAP)
<b>Background:</b> Severe community-acquired pneumonia (sCAP) is the most frequent admission for acute respiratory failure in intensive care medicine. Observational studies have found a correlation between patients who were admitted with CAP and the development of cardiovascular events....
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-12-01
|
| Series: | Antibiotics |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2079-6382/12/12/1710 |
| _version_ | 1797382272658178048 |
|---|---|
| author | Ignacio Martin-Loeches Giampaolo Maggi Emili Diaz Judith Marín-Corral Alfonso Guedea Marcos I. Restrepo Luis F. Reyes Alejandro Rodríguez |
| author_facet | Ignacio Martin-Loeches Giampaolo Maggi Emili Diaz Judith Marín-Corral Alfonso Guedea Marcos I. Restrepo Luis F. Reyes Alejandro Rodríguez |
| author_sort | Ignacio Martin-Loeches |
| collection | DOAJ |
| description | <b>Background:</b> Severe community-acquired pneumonia (sCAP) is the most frequent admission for acute respiratory failure in intensive care medicine. Observational studies have found a correlation between patients who were admitted with CAP and the development of cardiovascular events. The risk of acute myocardial damage in patients with CAP is particularly high within the first 30 days of hospitalization. <b>Research design and methods:</b> Multicenter prospective cohort analysis conducted in consecutive patients admitted to an ICU with microbiologically confirmed diagnoses of sCAP. The aim was to determine any structural cardiac damage detected by advanced imagining techniques (cardiac MRI) and cardiac biomarkers in patients with sCAP. The patients were stratified, according to their etiology, into pneumococcal or not-pneumococcal sCAP. The primary outcome was cardiac damage at day 5 and 7 of clinical presentation. <b>Results:</b> A total of 23 patients were consecutively and prospectively enrolled for two winter periods. No significant differences were observed between the median troponin when comparing the pneumococcal vs. non-pneumococcal. The incidence of myocardial damage was numerically higher in the pneumococcal subgroup (70% vs. 50%, <i>p</i> = 0.61) on day 5 and on day 7 (53% vs. 40%, <i>p</i> = 0.81) but did not achieve significance. Confirming a correlation between the biomarkers of cell damage and the biomarkers of myocardial damage, only a positive and significant correlation was observed between h-FABP and DNA on day 1 (r = 0.74; <i>p</i> < 0.01) and day 3 (r = 0.83; <i>p</i> < 0.010). Twenty cardiac MRIs were performed on the 23 patients (87%). No presence of fibrosis was observed in any of the studies carried out within the first 15 days of admission. <b>Conclusions:</b> No significant myocardial damage was found in patients with sCAP independent of the bacterial etiology in accordance with biomarker alterations (Troponin and/or h-FABP) or cardiac MRI. Using cardiac MRI, we could not find any presence of myocardial fibrosis within the first 15 days of admission. |
| first_indexed | 2024-03-08T21:03:03Z |
| format | Article |
| id | doaj.art-eab62a523c26446889e55486de520631 |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-08T21:03:03Z |
| publishDate | 2023-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-eab62a523c26446889e55486de5206312023-12-22T13:47:59ZengMDPI AGAntibiotics2079-63822023-12-011212171010.3390/antibiotics12121710A Multicentric Observational Study to Determine Myocardial Injury in Severe Community-Acquired Pneumonia (sCAP)Ignacio Martin-Loeches0Giampaolo Maggi1Emili Diaz2Judith Marín-Corral3Alfonso Guedea4Marcos I. Restrepo5Luis F. Reyes6Alejandro Rodríguez7Department of Intensive Care Medicine, Multidisciplinary Intensive Care Research Organization (MICRO), St James’s Hospital, D08NYH1 Dublin, Leinster, IrelandDepartment of Intensive Care Medicine, Multidisciplinary Intensive Care Research Organization (MICRO), St James’s Hospital, D08NYH1 Dublin, Leinster, IrelandCritical Care Department—Hospital Parc Tauli/UAB, 08208 Sabadell, SpainCritical Care Department—Hospital del Mar, 08003 Barcelona, SpainRadiology Department—Hospital Universitari de Tarragona Joan XXIII, 43005 Tarragona, SpainMedicine Department—South Texas Veterans Health Care System, University of Texas Health, San Antonio, TX 77030, USAUnisabana Center for Translational Science, School of Medicine, Universidad de La Sabana, Chia 250001, ColombiaCritical Care Department—Hospital Universitari de Tarragona Joan XXIII/URV/IISPV/CIBERES, 43005 Tarragona, Spain<b>Background:</b> Severe community-acquired pneumonia (sCAP) is the most frequent admission for acute respiratory failure in intensive care medicine. Observational studies have found a correlation between patients who were admitted with CAP and the development of cardiovascular events. The risk of acute myocardial damage in patients with CAP is particularly high within the first 30 days of hospitalization. <b>Research design and methods:</b> Multicenter prospective cohort analysis conducted in consecutive patients admitted to an ICU with microbiologically confirmed diagnoses of sCAP. The aim was to determine any structural cardiac damage detected by advanced imagining techniques (cardiac MRI) and cardiac biomarkers in patients with sCAP. The patients were stratified, according to their etiology, into pneumococcal or not-pneumococcal sCAP. The primary outcome was cardiac damage at day 5 and 7 of clinical presentation. <b>Results:</b> A total of 23 patients were consecutively and prospectively enrolled for two winter periods. No significant differences were observed between the median troponin when comparing the pneumococcal vs. non-pneumococcal. The incidence of myocardial damage was numerically higher in the pneumococcal subgroup (70% vs. 50%, <i>p</i> = 0.61) on day 5 and on day 7 (53% vs. 40%, <i>p</i> = 0.81) but did not achieve significance. Confirming a correlation between the biomarkers of cell damage and the biomarkers of myocardial damage, only a positive and significant correlation was observed between h-FABP and DNA on day 1 (r = 0.74; <i>p</i> < 0.01) and day 3 (r = 0.83; <i>p</i> < 0.010). Twenty cardiac MRIs were performed on the 23 patients (87%). No presence of fibrosis was observed in any of the studies carried out within the first 15 days of admission. <b>Conclusions:</b> No significant myocardial damage was found in patients with sCAP independent of the bacterial etiology in accordance with biomarker alterations (Troponin and/or h-FABP) or cardiac MRI. Using cardiac MRI, we could not find any presence of myocardial fibrosis within the first 15 days of admission.https://www.mdpi.com/2079-6382/12/12/1710sCAPsepsisseptic shockICUPneumoniaMOF |
| spellingShingle | Ignacio Martin-Loeches Giampaolo Maggi Emili Diaz Judith Marín-Corral Alfonso Guedea Marcos I. Restrepo Luis F. Reyes Alejandro Rodríguez A Multicentric Observational Study to Determine Myocardial Injury in Severe Community-Acquired Pneumonia (sCAP) Antibiotics sCAP sepsis septic shock ICU Pneumonia MOF |
| title | A Multicentric Observational Study to Determine Myocardial Injury in Severe Community-Acquired Pneumonia (sCAP) |
| title_full | A Multicentric Observational Study to Determine Myocardial Injury in Severe Community-Acquired Pneumonia (sCAP) |
| title_fullStr | A Multicentric Observational Study to Determine Myocardial Injury in Severe Community-Acquired Pneumonia (sCAP) |
| title_full_unstemmed | A Multicentric Observational Study to Determine Myocardial Injury in Severe Community-Acquired Pneumonia (sCAP) |
| title_short | A Multicentric Observational Study to Determine Myocardial Injury in Severe Community-Acquired Pneumonia (sCAP) |
| title_sort | multicentric observational study to determine myocardial injury in severe community acquired pneumonia scap |
| topic | sCAP sepsis septic shock ICU Pneumonia MOF |
| url | https://www.mdpi.com/2079-6382/12/12/1710 |
| work_keys_str_mv | AT ignaciomartinloeches amulticentricobservationalstudytodeterminemyocardialinjuryinseverecommunityacquiredpneumoniascap AT giampaolomaggi amulticentricobservationalstudytodeterminemyocardialinjuryinseverecommunityacquiredpneumoniascap AT emilidiaz amulticentricobservationalstudytodeterminemyocardialinjuryinseverecommunityacquiredpneumoniascap AT judithmarincorral amulticentricobservationalstudytodeterminemyocardialinjuryinseverecommunityacquiredpneumoniascap AT alfonsoguedea amulticentricobservationalstudytodeterminemyocardialinjuryinseverecommunityacquiredpneumoniascap AT marcosirestrepo amulticentricobservationalstudytodeterminemyocardialinjuryinseverecommunityacquiredpneumoniascap AT luisfreyes amulticentricobservationalstudytodeterminemyocardialinjuryinseverecommunityacquiredpneumoniascap AT alejandrorodriguez amulticentricobservationalstudytodeterminemyocardialinjuryinseverecommunityacquiredpneumoniascap AT ignaciomartinloeches multicentricobservationalstudytodeterminemyocardialinjuryinseverecommunityacquiredpneumoniascap AT giampaolomaggi multicentricobservationalstudytodeterminemyocardialinjuryinseverecommunityacquiredpneumoniascap AT emilidiaz multicentricobservationalstudytodeterminemyocardialinjuryinseverecommunityacquiredpneumoniascap AT judithmarincorral multicentricobservationalstudytodeterminemyocardialinjuryinseverecommunityacquiredpneumoniascap AT alfonsoguedea multicentricobservationalstudytodeterminemyocardialinjuryinseverecommunityacquiredpneumoniascap AT marcosirestrepo multicentricobservationalstudytodeterminemyocardialinjuryinseverecommunityacquiredpneumoniascap AT luisfreyes multicentricobservationalstudytodeterminemyocardialinjuryinseverecommunityacquiredpneumoniascap AT alejandrorodriguez multicentricobservationalstudytodeterminemyocardialinjuryinseverecommunityacquiredpneumoniascap |