Cardiovascular events after invasive pneumococcal disease: a retrospective cohort study

• Published in: International journal of infectious diseases 2024-10, Vol.147, p.107185, Article 107185
• Main Authors: Dulfer, Elisabeth A., Serbée, Milou J.V., Dirkx, Kirsten K.T., Schaars, Carel F., Wertheim, Heiman F.L., de Jonge, Marien I., Cremers, Amelieke J.H.
• Format: Article
• Language: English
• Subjects: Acute coronary syndrome; Cardiovascular event; Invasive pneumococcal disease; Streptococcus pneumoniae; Stroke
• ISSN: 1201-9712; 1878-3511; 1878-3511
• DOI: 10.1016/j.ijid.2024.107185

•Cardiovascular events (CVEs) are not uncommon in adults with invasive pneumococcal disease (IPD).•Patients with IPD with a history of alcohol abuse were at risk for acute coronary syndromes.•A body temperature >39.5 °C was the best clinical predictor of stroke.•Certain pneumococcal serotypes are predictors of CVEs, especially in the younger adult IPD population. This study aims to understand the magnitude of and mechanisms underlying the development of cardiovascular events (CVEs) in patients with invasive pneumococcal disease (IPD). We aimed to identify factors that contribute to the occurrence of CVEs within 1 year after admission and discuss implications for patient care. A multicentered cohort study included adult patients from four Dutch hospitals who had a positive blood culture for Streptococcus pneumoniae and any type of clinical manifestation between 2012 and 2020. Disease characteristics and microbiological data were systematically collected from electronic patient files. The main outcome measures were the occurrence of stroke and acute coronary syndromes (ACS). Of 914 eligible patients, 4.2% experienced a CVE within 1 year after admission for IPD. ACS mainly occurred in the first 2 weeks, whereas stroke developed throughout follow-up. Although ACS was positively associated with disease severity, the sole independent predictor was alcohol abuse (odds ratio [OR] 3.840, 95% confidence interval [CI] 1.108-13.303). Although stroke occurred in 6.3% of meningitis cases, the best clinical predictor of stroke was a body temperature >39.5 °C at admission (OR 3.117 [1.154-8.423]). In the adult IPD population aged