Low-grade endotoxemia is associated with cardiovascular events in community-acquired pneumonia.
J Infect
; 88(2): 89-94, 2024 Feb.
Article
en En
| MEDLINE
| ID: mdl-38000675
ABSTRACT
OBJECTIVES:
Community-acquired pneumonia (CAP) is associated with low-grade endotoxemia but its relationship with cardiovascular events (CVE) has not been investigated.METHODS:
We evaluated the incidence of CVE including myocardial infarction, stroke, and cardiovascular death in 523 adult patients hospitalized for CAP. Serum lipopolysaccharide (LPS) and zonulin, a marker of gut permeability, were analyzed in the cohort, that was followed-up during hospitalization and up to 43 months thereafter.RESULTS:
During the hospital-stay, 55 patients experienced CVE with a progressive increase from the lowest (0.6%) to highest LPS tertile (23.6%, p < 0.001). Logistic regression analyses showed that higher LPS tertile was independently associated with CVE; LPS significantly correlated with age, hs-CRP and zonulin. In a sub-group of 23 CAP patients, blood E. coli DNA was higher in patients compared to 24 controls and correlated with LPS. During the long-term follow-up, 102 new CVE were registered; the highest tertile of LPS levels was associated with incident CVE; Cox regression analysis showed that LPS tertiles, age, history of CHD, and diabetes independently predicted CVE.CONCLUSIONS:
In CAP low-grade endotoxemia is associated to short- and long-term risk of CVE. Further study is necessary to assess if lowering LPS by non-absorbable antibiotics may result in improved outcomes.Palabras clave
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Bases de datos:
MEDLINE
Asunto principal:
Neumonía
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Enfermedades Cardiovasculares
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Endotoxemia
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Accidente Cerebrovascular
Límite:
Adult
/
Humans
Idioma:
En
Revista:
J Infect
Año:
2024
Tipo del documento:
Article
País de afiliación:
Italia