Plaque-related vs. plaque-unrelated cardio and cerebrovascular events (CCVE) in hospitalized patients with community-acquired pneumonia (CAP): Preliminary results from the FAILCAP study (ClinicalTrials: NCT01143155)

Abstract The development of CCVE in patients with CAP might be influenced by the presence or absence of coronary atherosclerosis. To evaluate the incidence, risk factors and outcomes of hospitalized patients with CAP undergoing plaque-related vs. plaque-unrelated CCVE. An international, multicenter, prospective, observational study was performed on consecutive CAP patients hospitalized from Oct. 2009 to Oct. 2012 in 8 Respiratory Dpts. Among the 905 patients enrolled (59% males; median age: 76 years), the incidence of plaque-related and plaque-unrelated CCVE was 3% and 21% respectively [Table 1]. In-hospital mortality among patients who experienced plaque-related was higher in comparison to both those who experienced plaque-unrelated CCVE and the rest of the population (41% vs. 21% vs. 4%, p<0.001). Similar results were obtained with mortality at 30 days (48% vs. 29% vs. 6%, p<0.001) and re-hospitalization at 30 days (21% vs. 15% vs. 8%, p=0.014). Risk factors independently associated with the presence of CCVEs were age, ventilatory / blood pressure support and PSI Risk Class V. Further interventional trials on cardioprotective medications should be designed comparing patients with plaque-related vs. unrelated events. Table 1 On admission During Hospitalization Total Plaque-related Acute myocardial infarction 13 (1.4%) 8 (0.9%) 21 (2.3%) Stroke 4 (0.4%) 3 (0.3%) 7 (0.8%) Plaque-unrelated Acute heart failure 18 (2%) 15 (1.7%) 33 (3.6%) Arrhythmia 43 (4.8%) 31 (3.4%) 75 (8.3%) Acute mental status change 130 (14%) NA 130 (14%) Data are presented as n. (%)