Short-term cardiovascular events and mortality in elderly patients with stable coronary artery disease complicating acute lower respiratory tract infection：a risk review
ZHAO Xiao-qian
LUO Lei-ming
YE Ping
DU Rui-xue
XIAO Tie-hui
Abstract：Objective To discuss the incidence and risk factors of short-term (within 90 d) cardiovascular events (CVEs) and all-cause mortality in elderly patients with stable coronary artery disease (sCAD) complicating acute lower respiratory tract infection (ALRTI).Methods The elderly patients with sCAD hospitalized due to acute lower respiratory tract infection (infection group) and sCAD patients without acute lower respiratory tract infection (non-infection group) were chosen from Jan. 2011 to Dec. 2013. The incidences of CVEs and all-cause mortality were followed up for 7 d (D7), 30 d (D30) and 90 d (D90).Results There were totally 426 elderly sCAD patients included the analysis, among them 257 in infection group and 169 in non-infection group (average age=885). During follow-up period, the incidence of CVEs was 7.5% at D7, 15.0% at D30 and 24.6 % at D90, and incidence of all-cause mortality was 0.7% at D7, 2.6% at D30 and 8.7% D90 in whole cohort. The incidence of CVEs (10.9%vs. 2.4%,P=0.001) at D7, (20.6%vs. 6.5%,P<0.001) at D30 and (31.9%vs. 13.6%,P<0.001) at D90 was higher in infection group than those in non-infection group, and all-cause mortality (1.2%vs. 0%,P=0.28) at D7, (3.9%vs. 0.6%,P=0.021) at D30 and (13.2%vs. 1.8%,P<0.001) at D90 was also higher in infection group than those in non-infection group. In infection group, CVEs occurred centrally within 30 d and sCAD occurred centrally within 2 w, and there were no time laws in non-infection group. The multi-factor regression analysis showed that acute lower respiratory tract infection (OR=2.162, 95%CI: 1.023~4.569,P=0.043), chronic kidney disease (OR=2.086, 95%CI:1.085~4.013,P=0.028), admission respiratory rate≥24 time/min (OR=1.093, 95%CI: 1.006~1.187,P=0.036) and admission heart rate≥125 time/min (OR=1.018, 95%CI: 1.000~1.037,P=0.045) were independently correlated to risk increase of composite end-point of CVEs and all-cause mortality at D90. The short-term mortality was significantly higher in patients with sCAD than that in those without sCAD (P=0.004).Conclusion In elderly sCAD patients, the risk of short-term multiple cardiovascular events and all-cause mortality will increase when they suffer from acute lower respiratory tract infection. The effective prevention and active treatment of lower respiratory tract infection may reduce cardiovascular events and death in elderly CHD patients.
Keywords：Lower respiratory tract infectionInflammationCardiovascular eventsAll-cause mortality
Publication Date：2015-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 202-206,210 )