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Host- and Pathogen-Related Factors for Acute Cardiac Events in Pneumococcal Pneumonia Rombauts, Alexander Abelenda Alonso, Gabriela Càmara Mas, Jordi Lorenzo Esteller, Laia González-Díaz, Aida Sastre Escolà, Enric Gudiol González, Carlota Dorca i Sargatal, Jordi Tebé, Cristian Pallarès, Natàlia Ardanuy Tisaire, María Carmen Carratalà, Jordi Pneumònia adquirida a la comunitat Malalties del cor Community-acquired pneumonia Heart diseases Background: Acute cardiac events (ACEs) are increasingly being recognized as a major complication in pneumococcal community-acquired pneumonia (CAP). Information regarding host- and pathogen-related factors for ACEs, including pneumococcal serotypes and clonal complexes, is scarce. Methods: A retrospective study was conducted of a prospective cohort of patients hospitalized for CAP between 1996 and 2019. Logistic regression and funnel plot analyses were performed to determine host- and pathogen-related factors for ACEs. Results: Of 1739 episodes of pneumococcal CAP, 1 or more ACEs occurred in 304 (17.5%) patients, the most frequent being arrhythmia (n = 207), heart failure (n = 135), and myocardial infarction (n = 23). The majority of ACEs (73.4%) occurred within 48 hours of admission. Factors independently associated with ACEs were older age, preexisting heart conditions, pneumococcal bacteremia, septic shock at admission, and high-risk pneumonia. Among 983 pneumococcal isolates, 872 (88.7%) were serotyped and 742 (75.5%) genotyped. The funnel plot analyses did not find any statistically significant association between serotypes or clonal complexes with ACEs. Nevertheless, there was a trend toward an association between CC230 and these complications. ACEs were independently associated with 30-day mortality (adjusted odds ratio, 1.88; 95% CI, 1.11-3.13). Conclusions: ACEs are frequent in pneumococcal pneumonia and are associated with increased mortality. The risk factors defined in this study may help identify patients who must undergo close follow-up, including heart rhythm monitoring, and special care to avoid fluid overload, particularly during the first 48 hours of admission. These high-risk patients should be the target for preventive intervention strategies. 2021-06-08T07:56:57Z 2021-06-08T07:56:57Z 2020-10-26 2021-06-08T07:56:57Z info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Reproducció del document publicat a: https://doi.org/10.1093/ofid/ofaa522 Open Forum Infectious Diseases, 2020, vol. 7, num. 12 https://doi.org/10.1093/ofid/ofaa522 cc-by-nc-nd (c) Rombauts, Alexander et al., 2020 https://creativecommons.org/licenses/by-nc-nd/4.0/ info:eu-repo/semantics/openAccess Oxford University Press Articles publicats en revistes (Ciències Clíniques)