Low-grade endotoxemia is associated with cardiovascular events in community-acquired pneumonia
Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved..
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 sub-group 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.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:88 |
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| Enthalten in: |
The Journal of infection - 88(2024), 2 vom: 09. Feb., Seite 89-94 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Cangemi, Roberto [VerfasserIn] |
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| Links: |
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| Themen: |
Cardiovascular events |
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| Anmerkungen: |
Date Completed 07.02.2024 Date Revised 07.02.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.jinf.2023.11.010 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM364919264 |
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| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved. | ||
| 520 | |a OBJECTIVES: Community-acquired pneumonia (CAP) is associated with low-grade endotoxemia but its relationship with cardiovascular events (CVE) has not been investigated | ||
| 520 | |a 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 | ||
| 520 | |a 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 sub-group 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 | ||
| 520 | |a 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 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Cardiovascular events | |
| 650 | 4 | |a Community-acquired pneumonia | |
| 650 | 4 | |a Lipopolysaccharide | |
| 650 | 4 | |a Zonulin | |
| 650 | 7 | |a Lipopolysaccharides |2 NLM | |
| 700 | 1 | |a Carnevale, Roberto |e verfasserin |4 aut | |
| 700 | 1 | |a Nocella, Cristina |e verfasserin |4 aut | |
| 700 | 1 | |a Calvieri, Camilla |e verfasserin |4 aut | |
| 700 | 1 | |a Bartimoccia, Simona |e verfasserin |4 aut | |
| 700 | 1 | |a Frati, Giacomo |e verfasserin |4 aut | |
| 700 | 1 | |a Pignatelli, Pasquale |e verfasserin |4 aut | |
| 700 | 1 | |a Picchio, Vittorio |e verfasserin |4 aut | |
| 700 | 1 | |a Violi, Francesco |e verfasserin |4 aut | |
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