Cangemi, Roberto 
ORCID: 0000-0002-4097-2061, Carnevale, Roberto, Cammisotto, Vittoria, Nocella, Cristina, Bartimoccia, Simona ORCID: 0000-0002-6266-3059, Taliani, Gloria, Falcone, Marco, Calvieri, Camilla, Pignatelli, Pasquale ORCID: 0000-0002-2265-7455, Violi, Francesco ORCID: 0000-0002-6610-7068 et al (show 1 more authors)
(2022)
Corticosteroid use, myocardial injury and in-hospital cardiovascular events in patients with community-acquired pneumonia.
British journal of clinical pharmacology, 88 (1).
pp. 155-165.
Abstract
<h4>Background and purpose</h4>Corticosteroids are often prescribed to community-acquired pneumonia (CAP) patients, but the relationship with major cardiovascular events (MACEs) is unclear.<h4>Experimental approach</h4>541 CAP patients were recruited (334 males, mean age 71.9 ± 16.2 years). High-sensitivity troponin T (hs-cTnT) was measured at admission, during the hospital stay and at discharge. MACE occurrence was registered during a long-term follow-up.<h4>Key results</h4>Overall, 318 patients (59%) showed hs-cTnT elevation >99th percentile (>0.014 μg/L). Age, heart failure and the increasing quintiles of hs-cTnT (hazard ratio [HR] 2.16, 95% confidence interval [CI] 1.82-2.58, P < .001) predicted MACEs. Among patients with hs-cTnT >0.014 μg/L at admission, 102 patients (31%) were on corticosteroids and showed lower hs-cTnT increase (P = .021), (NADPH) oxidase-2 (Nox2) activation (P = .005) and incidence of MACEs than untreated ones (HR 0.64, 95% CI 0.41-0.97, P = .038); no effect of corticosteroids on MACEs was observed in CAP patients with normal troponin. In vitro study showed that glucocorticoids have an antioxidant effect via downregulation of Nox2 activity.<h4>Conclusion and implications</h4>The study provides evidence that corticosteroid use is associated with lower increase of hs-cTnT and incidence of MACEs in CAP patients.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | SIXTUS study group, Humans, Community-Acquired Infections, Pneumonia, Adrenal Cortex Hormones, Troponin T, Prognosis, Aged, Aged, 80 and over, Middle Aged, Hospitals, Male, Heart Failure, Biomarkers |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 06 May 2022 15:24 |
| Last Modified: | 18 Jan 2023 21:04 |
| DOI: | 10.1111/bcp.14936 |
| Open Access URL: | https://bpspubs.onlinelibrary.wiley.com/doi/10.111... |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3154393 |
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