The association of cardioprotective medications with pneumonia-related outcomes.
The association of cardioprotective medications with pneumonia-related outcomes.
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DOI：
10.1371/journal.pone.0085797
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发表时间：
2014-01-01
期刊：
影响因子：
3.7
通讯作者：
Mortensen, Eric M
中科院分区：
文献类型：
--
作者：
Wu, Albert;Good, Chester;Mortensen, Eric M
简介：很少有研究检查除了他汀类药物以外的心血管药物是否与肺炎后的预后改善相关。我们的目的是检查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）的使用与肺炎相关outcome.Materials AND Methods：我们对≥ 65岁的男性肺炎住院患者进行了一项回顾性人群研究，这些患者没有预先存在的心脏疾病。我们的主要分析是多水平回归模型，研究心血管药物类别和死亡率或心血管事件之间的关联。结果：我们的队列包括21，985例患者：22%在入院后90天内死亡，22%在90天内发生心脏事件。研究的与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，没有一种药物与降低心血管事件显著相关。讨论：虽然他汀类药物，ACE抑制剂，ARB，与降低死亡率，有没有降低心血管事件的显着关联。这些结果表明，由于其潜在的心脏保护作用，这种死亡率降低是不可能的。
INTRODUCTION: 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.MATERIALS AND METHODS: 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.RESULTS: 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.DISCUSSION: 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.