Российский кардиологический журнал (May 2024)

Predictors of cardiovascular events in patients with heart failure and <i>Pseudomonas aeruginosa</i> pneumonia

  • V. I. Podzolkov,
  • A. I. Tarzimanova,
  • L. A. Ponomareva,
  • E. E. Sokolova,
  • A. A. Chinova,
  • E. N. Popova,
  • A. B. Ponomarev,
  • I. Zh. Loria,
  • T. S. Vargina,
  • Zh. M. Sizova,
  • N. K. Ziskina

DOI
https://doi.org/10.15829/1560-4071-2024-5817
Journal volume & issue
Vol. 29, no. 4

Abstract

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Aim. To identify predictors of cardiovascular events (CVEs) in patients with heart failure (HF) and P. aeruginosa pneumonia.Material and methods. The study included 92 patients with HF with mildly reduced or reduced ejection fraction and nosocomial pneumonia. Based on sputum or bronchoalveolar lavage microbiological examination, patients were divided into 2 following groups: group I — 51 patients with HF and P. aeruginosa pneumonia, group II — 41 patients with HF and pneumonia caused by other pathogens (Staphylococcus aureus, Streptococcus pneumoniae). During the hospital stay, the following morbidities were assessed: cardiovascular death, acute coronary syndrome, non-fatal cerebrovascular accident, pulmonary embolism, lower extremity venous thrombosis.Results. CVEs were significantly more often observed in patients with HF and P. aeruginosa pneumonia — 30 (58,8%) than in patients with HF and pneumonia caused by S. aureus or S. pneumoniae — 5 (12,1%). Complete blood count in group I patients revealed a decrease in hemoglobin level to 114 [95; 133] g/l, when compared with patients in group II — 139 [118; 150] g/l (p<0,001) and an increase in white blood cell count (10,2×109/l and 6,96×109/l, respectively (p<0,001)). A biochemical blood test in group I patients revealed a significant increase in C-reactive protein (CRP) of 105 [60; 191] and 18 [14; 55,1] mg/l (p<0,001). Patients with P. aeruginosa pneumonia had more widespread lung involvement than patients with pneumonia of other etiologies.Conclusion. There are following most significant predictors of cardiovascular events in patients with HF and P. aeruginosa pneumonia: decreased LVEF <40% (relative risk (RR) 1,833; 95% confidence interval (CI) 1,188-3,400; p=0,005), white blood cell count >11×109/l (RR 2,412; 95% CI 1,399-4,158; p=0,048), CRP >133 mg/l (RR 3,115; 95% CI 1,611-6,025; p<0,001) and hypoproteinemia <57 g/l (RR 5,225; 95% CI 1,249-21,854; p=0,012).

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