Community-acquired pneumonia CAP is an important cause of death around the globe. Up to 30% of patients adm itt ed to hos pit al for CAP dev elo p car dio vas cul ar complications i. Cardiac co mp li ca ti on s re su lt fr om co mp le x in te ra ct io ns bet wee n pre exi sti ng con dit ion s, rel ati ve isc hae mia , up re gu la ti on of th e sy mp at he ti c sy st em, sys te mi c in ACE, angi oten sin- conv erti ng enzy me; ACS, acut e coro nary synd rome ; ARB, angi oten sin rece ptor bloc ker; CAP , co mmu nit y-a cqu ire d pn eum oni a; CC, car dio vas cul ar comp lica tion ; CRP, C-re acti ve prot ein; CVD, card iova scul ar dise ase; IPD, inva sive pneu moco ccal dise ase; MI, myoc ardi al infarction ; NHP, non-human primates; PAR, protease-a ctivated receptor; Ply, pneumolysin; RR, risk ratio; sP-selectin, soluble P- selectin; SRMA, systematic review and meta-analysis. Ther efo re, acq uiri ng a bet ter und erst and ing of the different groups affected by CVD, the causes and direct associa tions with frequent co-morbi dities e. CAP and oth er infe ctio ns and pot enti al str ate gies to mana ge these patients is a public health priority. In this review, we summarize current literature on the risk of CC, diagnostic methods, underlying mechanisms, potential ef fec ts of med ica ti on s an d ro le of im mun iz ati on in adult patients with CAP. Corresponden ce: Marcos I. Restrepo, Division of Pulmonary Dise ases and Criti cal Care Medicin e, Sout h Texa s Vete rans Health Care System, ALMD, 7400 Merton Minter Boulevard, San Antonio, TX 78229, USA. This article is a U. Government work and is in the public domain in the USA However, all these conditions seem to be over- represented among hosts with compromised immuno- lo gic al st at us, po te nti al ly le ad ing to po or cl ini ca l out com es. In add itio n, many of the se co- mor bid itie s are associated with poor functional and disability sta- tu s, us ual ly re qu iri ng ad mis sio n to lo ng- te rm ca re facilities. In addition, gender is also a risk fac- tor for long-term mortality and CVD, which is why both variables are included in the pneumonia severity scores that predict mortality. Patients with chronic CVD have up to three times inc reas ed risk of dev elop ing CAP , par tic ular ly tho se with heart failure. Both conditions are present in up to half and one- thi rd of the pat ient s, resp ecti vel y. The mos t imp ort ant con dit ion ass ocia ted with pri or CVD is atherosclerosis which affects more than one- third of the adult population. More than 50% of ath- erosclerotic CVD presents as coronary events, includ- in g su dd en ca rd ia c de at h, no n- fa ta l my oc ar di al infarction MI and revascularization, with the rest as str oke and cla udi cati on asso cia ted wit h per iph era l arterial disease. Consequently, identify- ing the mechanisms underlying cell death and cardiac dam age dur ing CAP is of vit al imp ort ance to und er- stand and prevent CC in patients with CAP. In the fol- l o w i n g se c t io n s, w e at t e m p t t o d e s c r ib e t h e transl ationa l research available that could potentiall y des crib e the host Import antly, mouse model s of pneumo coccal vaccinations have shown that animals which received the vaccinations had greater concentrations of antioxi- dizing low-d ensity lipop rotein anti- oxLDL antibo dies, which are known to reduce the size and promote stabi- lization of atherosclerotic plaques. Thrombus could be generated locally due to a mechanical stimuli and exposure to tissue fac- tor s e. CAP pat ient s eli cit a pro coag ulan t stat e seco nda ry to an ex ag ge ra te d ho st in.
