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Platelet Activation Is Associated With Myocardial Infarction in Patients With Pneumonia
- Source :
- Journal of the American College of Cardiology. (18):1917-1925
- Publisher :
- American College of Cardiology Foundation. Published by Elsevier Inc.
-
Abstract
- BackgroundTroponins may be elevated in patients with pneumonia, but associations with myocardial infarction (MI) and with platelet activation are still undefined.ObjectivesThe aim of this study was to investigate the relationship between troponin elevation and in vivo markers of platelet activation in the early phase of hospitalization of patients affected by community-acquired pneumonia.MethodsA total of 278 consecutive patients hospitalized for community-acquired pneumonia, who were followed up until discharge, were included. At admission, platelet activation markers such as plasma soluble P-selectin, soluble CD40 ligand, and serum thromboxane B2 (TxB2) were measured. Serum high-sensitivity cardiac troponin T levels and electrocardiograms were obtained every 12 and 24 h, respectively.ResultsAmong 144 patients with elevated high-sensitivity cardiac troponin T, 31 had signs of MI and 113 did not. Baseline plasma levels of soluble P-selectin and soluble CD40 ligand and serum TxB2 were significantly higher in patients who developed signs of MI. Logistic regression analysis showed plasma soluble CD40 ligand (p < 0.001) and soluble P-selectin (p < 0.001), serum TxB2 (p = 0.030), mean platelet volume (p = 0.037), Pneumonia Severity Index score (p = 0.030), and ejection fraction (p = 0.001) to be independent predictors of MI. There were no significant differences in MI rate between the 123 patients (45%) taking aspirin (100 mg/day) and those who were not aspirin treated (12% vs. 10%; p = 0.649). Aspirin-treated patients with MIs had higher serum TxB2 compared with those without MIs (p = 0.005).ConclusionsMI is an early complication of pneumonia and is associated with in vivo platelet activation and serum TxB2 overproduction; aspirin 100 mg/day seems insufficient to inhibit thromboxane biosynthesis. (MACCE in Hospitalized Patients With Community-acquired Pneumonia; NCT01773863)
- Subjects :
- Male
medicine.medical_specialty
Thromboxane
CD40 Ligand
Myocardial Infarction
chemistry.chemical_compound
Electrocardiography
Troponin T
cardiovascular disease
Internal medicine
medicine
Humans
risk factors
Platelet activation
Myocardial infarction
human
Aged
Aspirin
COPD
biology
business.industry
platelet aggregation
prospective studies
Pneumonia
Middle Aged
medicine.disease
Platelet Activation
Prognosis
Troponin
Thromboxane B2
Community-Acquired Infections
P-Selectin
chemistry
Cardiology
biology.protein
Female
Cardiology and Cardiovascular Medicine
business
Biomarkers
Platelet Aggregation Inhibitors
medicine.drug
Follow-Up Studies
Subjects
Details
- Language :
- English
- ISSN :
- 07351097
- Issue :
- 18
- Database :
- OpenAIRE
- Journal :
- Journal of the American College of Cardiology
- Accession number :
- edsair.doi.dedup.....f4e21f265896d9226fd4916e400b299e
- Full Text :
- https://doi.org/10.1016/j.jacc.2014.07.985