Cardiac Complications in Patients with Community-Acquired Pneumonia A Systematic Review and Meta-Analysis of Observational Studies 英文参考文献.docVIP

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Cardiac Complications in Patients with Community-Acquired Pneumonia A Systematic Review and Meta-Analysis of Observational Studies 英文参考文献.doc

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Cardiac Complications in Patients with Community-Acquired Pneumonia A Systematic Review and Meta-Analysis of Observational Studies 英文参考文献

CardiacComplicationsinPatientswithCommunity- AcquiredPneumonia:ASystematicReviewandMeta- AnalysisofObservationalStudies VicenteF.Corrales-Medina1,2*,KathrynN.Suh1,2,GregoryRose1,2,JulioA.Chirinos3,SteveDoucette1,2, D.WilliamCameron1,2,DeanA.Fergusson1,2 1Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada, 2Ottawa Hospital Research Institute, Ottawa, Ontario, Canada, 3Department of Medicine, UniversityofPennsylvania,Philadelphia,Pennsylvania,UnitedStatesofAmerica Abstract Background:Community-acquiredpneumonia(CAP)isaleadingcauseofmorbidityandmortality.CAPcantriggeracute cardiacevents.WesoughttodeterminetheincidenceofmajorcardiaccomplicationsinCAPpatientstocharacterizethe magnitudeofthisproblem. Methods and Findings: Two investigators searched MEDLINE, Scopus, and EMBASE for observational studies of immunocompetentadultswithclinicalandradiologicalevidenceofCAPthatreportedanyofthefollowing:overallcardiac complications,incidentheartfailure,acutecoronarysyndromes(ACS),orincidentcardiacarrhythmiasoccurringwithin30 daysofCAPdiagnosis.Ataminimum,studieshadtoestablishenrolmentproceduresandinclusionandexclusioncriteria, enrol their patients sequentially, and report the incidence of cardiac complications as a function of their entire cohorts. Studieswithfocusonnosocomialorhealthcare–associatedpneumoniawerenotincluded.Reviewof2,176citationsyielded 25articlesthatmeteligibilityandminimumqualitycriteria.Seventeenarticles(68%)reportedcohortsofCAPinpatients.In thisgroup,thepooledincidenceratesforoverallcardiaccomplications(sixcohorts,2,119patients),incidentheartfailure (eightscohorts,4,215patients),acutecoronarysyndromes(sixcohorts,2,657patients),andincidentcardiacarrhythmias(six cohorts,2,596patients),were17.7%(confidenceinterval[CI]13.9–22.2),14.1%(9.3–20.6),5.3%(3.2–8.6),and4.7%(2.4–8.9), respectively.OnearticlereportedcardiaccomplicationsinCAPoutpatients,fourinlow-risk(notseverelyill)inpatients,and threeinhigh-riskinpatients.Theincidencesforalloutcomesexce