Association between hospitalization for pneumonia and subsequent risk of cardiovascular disease

Vicente F. Corrales-Medina, Karina N. Alvarez, Lisa A. Weissfeld, Derek C. Angus, Julio A. Chirinos, Chung Chou H Chang, Anne Newman, Laura Loehr, Aaron R. Folsom, Mitchell S. Elkind, Mary F. Lyles, Richard A. Kronmal, Sachin Yende

Research output: Contribution to journalArticlepeer-review

194 Scopus citations

Abstract

IMPORTANCE: The risk of cardiovascular disease (CVD) after infection is poorly understood. OBJECTIVE: To determine whether hospitalization for pneumonia is associated with an increased short-term and long-term risk of CVD. DESIGN, SETTINGS, AND PARTICIPANTS: We examined 2 community-based cohorts: the Cardiovascular Health Study (CHS, n = 5888; enrollment age, ≥65 years; enrollment period, 1989-1994) and the Atherosclerosis Risk in Communities study (ARIC, n = 15 792; enrollment age, 45-64 years; enrollment period, 1987-1989). Participants were followed up through December 31, 2010. We matched each participant hospitalized with pneumonia to 2 controls. Pneumonia cases and controls were followed for occurrence of CVD over 10 years after matching. We estimated hazard ratios (HRs) for CVD at different time intervals, adjusting for demographics, CVD risk factors, subclinical CVD, comorbidities, and functional status. EXPOSURES: Hospitalization for pneumonia. MAIN OUTCOMES AND MEASURES: Incident CVD (myocardial infarction, stroke, and fatal coronary heart disease). RESULTS: Of 591 pneumonia cases in CHS, 206 had CVD events over 10 years after pneumonia hospitalization. Compared with controls, CVD risk among pneumonia cases was highest during the first year after hospitalization and remained significantly higher than among controls through 10 years. In ARIC, of 680 pneumonia cases, 112 had CVD events over 10 years after hospitalization. After the second year, CVD risk among pneumonia cases was not significantly higher than among controls. (Table presented.) CONCLUSIONS AND RELEVANCE: Hospitalization for pneumonia was associated with increased short-term and long-term risk of CVD, suggesting that pneumonia may be a risk factor for CVD.

Original languageEnglish (US)
Pages (from-to)264-274
Number of pages11
JournalJAMA - Journal of the American Medical Association
Volume313
Issue number3
DOIs
StatePublished - Jan 20 2015

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