• Vicente F Corrales-Medina, Karina N Alvarez, Lisa A Weissfeld, Derek C Angus, Julio A Chirinos, Chung-Chou H Chang, Anne Newman, Laura Loehr, Aaron R Folsom, Mitchell S Elkind, Mary F Lyles, Richard A Kronmal, and Sachin Yende.
• Department of Medicine, University of Ottawa, Ottawa Ontario, Canada2Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
• JAMA. 2015 Jan 20; 313 (3): 264-74.

ImportanceThe risk of cardiovascular disease (CVD) after infection is poorly understood.ObjectiveTo determine whether hospitalization for pneumonia is associated with an increased short-term and long-term risk of CVD.Design, Settings, And ParticipantsWe examined 2 community-based cohorts: the Cardiovascular Health Study (CHS, n = 5888; enrollment age, ≥65 years; enrollment period, 1989-1994) and the Atherosclerosis Risk in Communities study (ARIC, n = 15,792; enrollment age, 45-64 years; enrollment period, 1987-1989). Participants were followed up through December 31, 2010. We matched each participant hospitalized with pneumonia to 2 controls. Pneumonia cases and controls were followed for occurrence of CVD over 10 years after matching. We estimated hazard ratios (HRs) for CVD at different time intervals, adjusting for demographics, CVD risk factors, subclinical CVD, comorbidities, and functional status.ExposuresHospitalization for pneumonia.Main Outcomes And MeasuresIncident CVD (myocardial infarction, stroke, and fatal coronary heart disease).ResultsOf 591 pneumonia cases in CHS, 206 had CVD events over 10 years after pneumonia hospitalization. CVD risk after pneumonia was highest in the first year. CVD occurred in 54 cases and 6 controls in the first 30 days (HR, 4.07; 95% CI, 2.86-5.27); 11 cases and 9 controls between 31 and 90 days (HR, 2.94; 95% CI, 2.18-3.70); and 22 cases and 55 controls between 91 days and 1 year (HR, 2.10; 95% CI, 1.59-2.60). Additional CVD risk remained elevated into the tenth year, when 4 cases and 12 controls developed CVD (HR, 1.86; 95% CI, 1.18-2.55). In ARIC, of 680 pneumonia cases, 112 had CVD over 10 years after hospitalization. CVD occurred in 4 cases and 3 controls in the first 30 days (HR, 2.38; 95% CI, 1.12-3.63); 4 cases and 0 controls between 31 and 90 days (HR, 2.40; 95% CI, 1.23-3.47); 11 cases and 8 controls between 91 days and 1 year (HR, 2.19; 95% CI, 1.20-3.19); and 8 cases and 7 controls during the second year (HR, 1.88; 95% CI, 1.10-2.66). After the second year, the HRs were no longer statistically significant.Conclusions And RelevanceHospitalization for pneumonia was associated with increased short-term and long-term risk of CVD, suggesting that pneumonia may be a risk factor for CVD.

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