Elevated Hemostasis Markers after Pneumonia Increases One-Year Risk of All-Cause and Cardiovascular Deaths 英文参考文献.docVIP

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Elevated Hemostasis Markers after Pneumonia Increases One-Year Risk of All-Cause and Cardiovascular Deaths 英文参考文献.doc

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Elevated Hemostasis Markers after Pneumonia Increases One-Year Risk of All-Cause and Cardiovascular Deaths 英文参考文献

ElevatedHemostasisMarkersafterPneumoniaIncreases One-YearRiskofAll-CauseandCardiovascularDeaths SachinYende1,2*,GinaD’Angelo3,FlorianMayr1,2,JohnA.Kellum1,2,LisaWeissfeld2,4,A.Murat Kaynar1,2,TammyYoung1,2,KaikobadIrani5,DerekC.Angus1,2,fortheGenIMSInvestigators 1The Clinical Research, Investigation, and Systems Modeling of Acute Illness Center, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America, 2Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America, 3Division of Biostatistics, Washington University SchoolofMedicine,St.Louis,Missouri,UnitedStatesofAmerica,4DivisionofBiostatistics,UniversityofPittsburgh,Pittsburgh,Pennsylvania,UnitedStatesofAmerica, 5DivisionofCardiology,UniversityofPittsburgh,Pittsburgh,Pennsylvania,UnitedStatesofAmerica Abstract Background: Acceleration of chronic diseases, particularly cardiovascular disease, may increase long-term mortality after community-acquiredpneumonia(CAP),butunderlyingmechanismsareunknown.Persistenceoftheprothromboticstate that occurs during an acute infection may increase risk of subsequent atherothrombosis in patients with pre-existing cardiovascular disease and increase subsequent risk of death. We hypothesized that circulating hemostasis markers activatedduringCAPpersistathospitaldischarge,whenpatientsappeartohaverecoveredclinically,andareassociated withhighermortality,particularlyduetocardiovascularcauses. Methods:InacohortofsurvivorsofCAPhospitalizationfrom28USsites,wemeasuredD-Dimer,thrombin-antithrombin complexes[TAT],FactorIX,antithrombin,andplasminogenactivatorinhibitor-1athospitaldischarge,anddetermined1- yearall-causeandcardiovascularmortality. Results: Of 893 subjects, most did not have severe pneumonia (70.6% never developed severe sepsis) and only 13.4% required intensive care unit admission. At discharge, 88.4% of subjects had normal vital signs and appeared to have clinicallyrecovered.D-dimerandTATlevelswereelevatedat