Acute cardiovascular events in patients with pneumonia and cardiovascular comorbidities

Abstract

Background. Community-acquired pneumonia represents a major cause of morbidity and mortality, in patients with cardiovascular comorbidities. The interaction between the pulmonary infectious process and the cardiovascular system can lead to acute events, such as acute coronary syndrome and arrhythmias. Objective(s). Evaluation of the incidence, types and timing of occurrence of acute cardiovascular events occurring during hospitalization in patients with pneumonia and preexisting cardiovascular diseases. Materials and methods. Scientific articles were analyzed using electronic databases: PubMed, ScienceDirect, ResearchGate and bibliographic sources from the "Nicolae Testemițanu" University of Medicine and Pharmacy Medical Scientific Library. We examined data from recent literature, including multicenter observational studies and systematic meta-analyses. Results. The integrated analysis shows an incidence of acute cardiovascular events from 20% to 35% of cases with community pneumonia and cardiovascular comorbidities. In this context, acute heart failure was found in 15-16% of patients, atrial fibrillation constituting 8-9% of cases, and acute coronary syndromes were present in 2-3% of patients. In most cases, complications occur in the first 3 days after hospitalization, triggered by the impact of infectious inflammation on the function of the myocardium and vascular endothelium through changes in nitric oxide synthesis, cyclooxygenase and activation of platelet function. Conclusion(s). Acute heart failure was found to be the most frequent acute event in patients with community-acquired pneumonia and cardiovascular comorbidities. Careful monitoring of these patients could contribute to the early identification and effective management of these complications.