MYOCARDIAL INFARCTION AMONG HOSPITALIZED PATIENTS WITH COMMUNITY ACQUIRED PNEUMONIA: A RETROSPECTIVE OBSERVATIONAL STUDY

Abstract

Background: Pneumonia combined with influenza is a leading cause of death worldwide. There is an increased risk of acute myocardial infarction in patients with respiratory tract infection during hospitalization and after discharge. This study aimed to determine the frequency of myocardial infarction (MI) in hospitalized patients with community acquired pneumonia (CAP). Methods: A retrospective observational study was conducted at a tertiary care hospital in Islamabad, Pakistan. A total of 209 adult patients admitted from May 2018 to Dec 2020 with primary diagnosis of CAP were identified using local ICD code. Paper chart review for clinical parameters including symptoms, laboratory values, and radiological findings was performed. Severity of pneumonia was determined using CURB-65 score. Acute MI was diagnosed on elevated troponin and electrocardiogram findings. Univariate and multivariable analyses was performed for risk factors, co-morbidities, demographics, CAP severity at the time of admission, lab values and radiological findings and p<0.05 was considered statistically significant. Results: Males were 121 (58%) and females were 88 (42%) in the study. Incidence of acute MI in CAP patients was 10.52%. Only one patient experienced ST-elevation myocardial infarction (STEMI); the rest had non-ST-elevation myocardial infarction (NSTEMI). There was significant association between MI and history of ischemic heart diseases, angina, cardiomyopathy, acute kidney injury and pulmonary oedema (p?0.05). A significant increase in trend of acute MI was observed across the CURB-65 scores. Conclusion: The incidence of acute MI among hospitalized patients with CAP was 10.52%. Early recognition and prompt treatment will improve outcomes.

Pak J Physiol 2023;19(2):36?9