Objectives: Community-acquired pneumonia (CAP) is associated with low-grade endotoxemia but its relationship with cardiovascular events (CVE) has not been investigated.Methods: We evaluated the incidence of CVE including myocardial infarction, stroke, and cardiovascular death in 523 adult patients hospitalized for CAP. Serum lipopolysaccharide (LPS) and zonulin, a marker of gut permeability, were analyzed in the cohort, that was followed-up during hospitalization and up to 43 months thereafter.Results: During the hospital-stay, 55 patients experienced CVE with a progressive increase from the lowest (0.6%) to highest LPS tertile (23.6%, p < 0.001). Logistic regression analyses showed that higher LPS tertile was independently associated with CVE; LPS significantly correlated with age, hs-CRP and zonulin. In a subgroup of 23 CAP patients, blood E. coli DNA was higher in patients compared to 24 controls and correlated with LPS. During the long-term follow-up, 102 new CVE were registered; the highest tertile of LPS levels was associated with incident CVE; Cox regression analysis showed that LPS tertiles, age, history of CHD, and diabetes independently predicted CVE.Conclusions: In CAP low-grade endotoxemia is associated to short- and long-term risk of CVE. Further study is necessary to assess if lowering LPS by non-absorbable antibiotics may result in improved outcomes. (c) 2023 The Author(s). Published by Elsevier Ltd on behalf of The British Infection Association.

Low-grade endotoxemia is associated with cardiovascular events in community-acquired pneumonia / Cangemi, Roberto; Carnevale, Roberto; Nocella, Cristina; Calvieri, Camilla; Bartimoccia, Simona; Frati, Giacomo; Pignatelli, Pasquale; Picchio, Vittorio; Violi, Francesco. - In: JOURNAL OF INFECTION. - ISSN 0163-4453. - 88:2(2024), pp. 89-94. [10.1016/j.jinf.2023.11.010]

Low-grade endotoxemia is associated with cardiovascular events in community-acquired pneumonia

Cangemi, Roberto;Carnevale, Roberto;Nocella, Cristina;Frati, Giacomo;Pignatelli, Pasquale;
2024

Abstract

Objectives: Community-acquired pneumonia (CAP) is associated with low-grade endotoxemia but its relationship with cardiovascular events (CVE) has not been investigated.Methods: We evaluated the incidence of CVE including myocardial infarction, stroke, and cardiovascular death in 523 adult patients hospitalized for CAP. Serum lipopolysaccharide (LPS) and zonulin, a marker of gut permeability, were analyzed in the cohort, that was followed-up during hospitalization and up to 43 months thereafter.Results: During the hospital-stay, 55 patients experienced CVE with a progressive increase from the lowest (0.6%) to highest LPS tertile (23.6%, p < 0.001). Logistic regression analyses showed that higher LPS tertile was independently associated with CVE; LPS significantly correlated with age, hs-CRP and zonulin. In a subgroup of 23 CAP patients, blood E. coli DNA was higher in patients compared to 24 controls and correlated with LPS. During the long-term follow-up, 102 new CVE were registered; the highest tertile of LPS levels was associated with incident CVE; Cox regression analysis showed that LPS tertiles, age, history of CHD, and diabetes independently predicted CVE.Conclusions: In CAP low-grade endotoxemia is associated to short- and long-term risk of CVE. Further study is necessary to assess if lowering LPS by non-absorbable antibiotics may result in improved outcomes. (c) 2023 The Author(s). Published by Elsevier Ltd on behalf of The British Infection Association.
2024
Cardiovascular events; Community-acquired pneumonia; Lipopolysaccharide; Zonulin
01 Pubblicazione su rivista::01a Articolo in rivista
Low-grade endotoxemia is associated with cardiovascular events in community-acquired pneumonia / Cangemi, Roberto; Carnevale, Roberto; Nocella, Cristina; Calvieri, Camilla; Bartimoccia, Simona; Frati, Giacomo; Pignatelli, Pasquale; Picchio, Vittorio; Violi, Francesco. - In: JOURNAL OF INFECTION. - ISSN 0163-4453. - 88:2(2024), pp. 89-94. [10.1016/j.jinf.2023.11.010]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1705207
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