Zhao Xiaoqian, Liu Yuan, Zhang Jinping, Fu Shihui, Song Chengyun, Bai Yongyi, Luo Leiming
Department of Cardiology, The Second Medical Center, National Clinical Research Center for Geriatric Diseases, Beijing Key Laboratory of Chronic Heart Failure Precision Medicine, Chinese PLA General Hospital, Beijing, China.
Department of Cardiology, Chinese PLA 305 Hospital, Beijing, China.
Front Cardiovasc Med. 2021 Sep 17;8:711264. doi: 10.3389/fcvm.2021.711264. eCollection 2021.
To investigate the predictors of acute cardiovascular events within 90 days after an acute lower respiratory tract infection (ALRTI) in elderly patients with stable coronary artery disease (sCAD). Observational analyses were conducted in a prospective cohort of the elderly with sCAD, during 90 days after they were hospitalized for ALRTI. Multiple logistic regression analysis was performed to identify predictors for acute cardiovascular events and all-cause mortality. The present study comprised 426 patients with sCAD (median age: 88 years; IQR: 84-91; range: 72-102). Among these patients, 257 suffering from ALRTI were enrolled in the infection group. Meanwhile, 169 patients who did not suffer from ALRTI were regarded as the non-infection group. Compared with the non-infection group, patients in the infection group had a higher incidence of acute cardiovascular events (31.9 vs. 13.6%, < 0.001) and all-cause mortality (13.2 vs. 1.8%, < 0.001) during the 90-day follow-up. In addition, in the infection group, the incidence of cardiovascular events was also higher than those in the non-infection group during the 7-day and 30-day follow-up (10.9 vs. 2.4%, = 0.001; 20.6 vs. 6.5%, < 0.001). The same difference in the incidence of all-cause mortality during 7 and 30 days (1.2 vs. 0%, = 0.028; 3.9 vs. 0.6%, = 0.021) was observed between the two groups. Furthermore, multiple regression analysis found that ALRTI was independently associated with increased risk of cardiovascular events and all-cause mortality in elderly patients with sCAD. In elderly patients with sCAD, ALRTI was an independent predictor for both cardiovascular events and all-cause mortality.
探讨老年稳定型冠状动脉疾病（sCAD）患者急性下呼吸道感染（ALRTI）后90天内急性心血管事件的预测因素。对sCAD老年患者的前瞻性队列进行观察性分析，观察时间为他们因ALRTI住院后的90天内。进行多因素逻辑回归分析以确定急性心血管事件和全因死亡率的预测因素。本研究纳入了426例sCAD患者（中位年龄：88岁；四分位间距：84 - 91岁；范围：72 - 102岁）。其中，257例患有ALRTI的患者被纳入感染组。同时，169例未患ALRTI的患者被视为非感染组。与非感染组相比，感染组患者在90天随访期间急性心血管事件发生率更高（31.9%对13.6%，<0.001），全因死亡率也更高（13.2%对1.8%，<0.001）。此外，在感染组中，7天和30天随访期间心血管事件发生率也高于非感染组（10.9%对2.4%，=0.001；20.6%对6.5%，<0.001）。两组在7天和30天全因死亡率发生率上也存在同样差异（1.2%对0%，=0.028；3.9%对0.6%，=0.021）。此外，多因素回归分析发现，ALRTI与sCAD老年患者心血管事件风险增加和全因死亡率独立相关。在sCAD老年患者中，ALRTI是心血管事件和全因死亡率的独立预测因素。
