Clinical features in adult patients with in-hospital cardiovascular events with confirmed 2009 Influenza A (H1N1) virus infection: Comparison with those without in-hospital cardiovascular events

• Published in: Journal of the Chinese Medical Association 2012-09, Vol.75 (9), p.435-441
• Main Authors: Song, Bong Gun, Wi, Yu Mi, Lee, Yu-Ji, Hong, Chong Kun, Chun, Woo Jung, Oh, Ju Hyun
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; APACHE; C-reactive protein; C-Reactive Protein - analysis; cardiovascular disease; Cardiovascular Diseases - etiology; cardiovascular mortality; Chest; Comorbidity; congestive heart failure; Coronary heart disease; Data processing; Diabetes mellitus; Dyspnea; EKG; Electrocardiography; Female; Geriatrics; Glucose; Heart rate; Hospitals; Humans; Hypertension; Infection; Influenza A; Influenza A Virus, H1N1 Subtype; Influenza, Human - complications; Internal Medicine; Leukocytes; Male; Middle Aged; Mortality; Natriuretic Peptide, Brain - blood; Pain; Peptide Fragments - blood; Respiration
• ISSN: 1726-4901; 1728-7731
• DOI: 10.1016/j.jcma.2012.06.015

Abstract Background Comprehensive data regarding in-hospital cardiovascular events of adults with confirmed 2009 influenza A (H1N1) (2009 H1N1) infections are limited. The aim of this study was to determine the clinical characteristics, laboratory parameters, and electrocardiographic (ECG) findings for adults with 2009 H1N1 infections and to assess the differences in these parameters among adult patients with and without in-hospital cardiovascular events. Methods Seventy-one patients were enrolled from the 2009 H1N1 registry database (our hospital registry of confirmed 2009 H1N1 infection during the year 2009) and divided according to the presence of in-hospital cardiovascular events. Six patients had cardiovascular events (CV group) and 65 did not (NCV group). Results The CV group was more likely to be old ( p = 0.023). Regarding co-morbidities, underlying coronary heart disease ( p = 0.001), congestive heart failure ( p = 0.001), diabetes ( p = 0.001), and hypertension ( p = 0.014) had significant influences on cardiovascular events. The CV group was also more likely to have chest pain ( p = 0.034), dyspnea ( p = 0.045), higher leukocyte count ( p = 0.014), higher C-reactive protein ( p = 0.010), higher glucose level ( p = 0.001), and higher N-terminal probrain natriuretic peptide level ( p = 0.010) than the NCV group. In addition, the CV group had a significantly higher in-hospital mortality rate ( p  = 0.010) and cardiac mortality rate ( p  = 0.001) than the NCV group. However, there were no significant differences in ECG findings between the two groups. Conclusion Our study demonstrated that the CV group had higher in-hospital and cardiac mortality rates than the NCV group. A meticulous therapeutic approach should be considered for elderly patients with 2009 H1N1 infections having coronary heart disease, congestive heart failure, diabetes, hypertension, and high levels of leukocyte count, hs-CRP, glucose, and NT-proBNP at the time of admission.