Wednesday June 25, 2008
Is Acute Myocardial Infarction (AMI) and Community Acquired Pneumonia interrelated ?

A recently published retrospective observational study by Julio Ramirez shed some light on it.

Data for 500 consecutive patients admitted to hospital with community acquired pneumonia (CAP) was performed. Clinical failure was defined as the development of respiratory failure or shock. AMI was diagnosed on the basis of abnormal troponin levels and EKG findings. At hospital admission, AMI was present in 13 (15%) of 86 patients with severe CAP. During hospitalization, AMI was present in 13 (20%) of 65 patients who experienced clinical failures. Following risk adjustment, significant associations were discovered between AMI and the pneumonia severity index score and between AMI and clinical failure (p less than 0.05).

Conclusion: A combined diagnosis of CAP and AMI is common among hospitalized patients with severe CAP. In CAP patients whose clinical course is complicated by clinical failure, AMI should be considered as a possible etiology.

Editor’s comment: This study raises an important issue which we commonly observe in our ICU patients. This study suggests a need for prospective well designed trial.


Reference: click to get abstract

Ramirez J, Alibert S, Mirsaeidi M, Peyrani P, et al. Acute Myocardial Infarction in Hospitalized Patients with Community-Acquired Pneumonia. Clinical Infectious Diseases 2008;47:182–187