Wu Albert, Good Chester, Downs John R, Fine Michael J, Pugh Mary Jo V, Anzueto Antonio, Mortensen Eric M
Medical Service, South Texas Veterans Health Care System, San Antonio, Texas, United States of America ; Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States of America.
VA Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, United States of America ; Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America.
PLoS One. 2014 Jan 28;9(1):e85797. doi: 10.1371/journal.pone.0085797. eCollection 2014.
Little research has examined whether cardiovascular medications, other than statins, are associated with improved outcomes after pneumonia. Our aim was to examine the association between the use of beta-blockers, statins, angiotensin converting enzyme (ACE) inhibitors, and angiotensin II receptor blockers (ARBs) with pneumonia-related outcomes.
We conducted a retrospective population-based study on male patients ≥ 65 years of age hospitalized with pneumonia and who did not have pre-existing cardiac disease. Our primary analyses were multilevel regression models that examined the association between cardiovascular medication classes and either mortality or cardiovascular events.
Our cohort included 21,985 patients: 22% died within 90 days of admission, and 22% had a cardiac event within 90 days. The cardiovascular medications studied that were associated with decreased 90-day mortality included: statins (OR 0.70, 95% CI 0.63-0.77), ACE inhibitors (OR 0.82, 95% CI 0.74-0.91), and ARBs (OR 0.58, 95% CI 0.44-0.77). However, none of the medications were significantly associated with decreased cardiovascular events.
While statins, ACE inhibitors, and ARBs, were associated with decreased mortality, there was no significant association with decreased CV events. These results indicate that this decreased mortality is unlikely due to their potential cardioprotective effects.
除他汀类药物外，很少有研究探讨心血管药物是否与肺炎后改善的预后相关。我们的目的是研究使用β受体阻滞剂、他汀类药物、血管紧张素转换酶（ACE）抑制剂和血管紧张素II受体阻滞剂（ARB）与肺炎相关预后之间的关联。
我们对年龄≥65岁、因肺炎住院且无既往心脏病史的男性患者进行了一项基于人群的回顾性研究。我们的主要分析是多水平回归模型，用于检验心血管药物类别与死亡率或心血管事件之间的关联。
我们的队列包括21985名患者：22%在入院后90天内死亡，22%在90天内发生心血管事件。研究发现与90天死亡率降低相关的心血管药物包括：他汀类药物（OR 0.70，95%CI 0.63 - 0.77）、ACE抑制剂（OR 0.82，95%CI 0.74 - 0.91）和ARB（OR 0.58，95%CI 0.44 - 0.77）。然而，没有一种药物与心血管事件减少有显著关联。
虽然他汀类药物、ACE抑制剂和ARB与死亡率降低相关，但与心血管事件减少没有显著关联。这些结果表明，死亡率降低不太可能是由于它们潜在的心脏保护作用。
