KYAMC Journal Vol. 10, No.4, January 2020 Original Article Cardiovascular Events in Adults With Community Acquired Pneumonia Muhammad Ashraful Kabir 1 , Mohammed Khorshed Alam 2 , Barkot Ali 3 , SK. Anisur Rahman 4 . 1. Assistant Professor, Department of Medicine, Gazi Medical College, Khulna, Bangladesh. 2. Assistant Professor, Department of Medicine (Gartro-enterology), Gazi Medical College Hospital, Khulna, Bangladesh. 3. Associate Professor,Department of Pediatrics, Gazi Medical College ,Khulna, Bangladesh. 4. Consultant, Department of Medicine (Cardiology), Gazi Medical College Hospital, Khulna, Bangladesh Correspondent: Muhammad Ashraful Kabir, Assistant Professor, Department of Medicine, Gazi Medical College (GMC), Khulna, Bangladesh. Mobile No :+8801711308592, E-mail:dr.kabir50@gmail.com Introduction Community-acquired pneumonia (CAP) is the most frequent infectious disease, responsible for a great morbidity and mortality worldwide. It is known that poor outcome in CAP patients is not only directly related to pneumonia but also to comorbidities both during hospitalization and long term after discharge. 1 The clinical presentation of CAP varies, ranging from mild pneumonia characterized by fever and productive cough to severe pneumonia characterized by respiratory distress and sepsis. Because of the wide spectrum of associated clinical features, CAP is a part of the differential diagnosis of nearly all respiratory illnesses. CAP is one of the most common and morbid conditions encountered in clinical practice. 2-4 In the United States, CAP accounts for over 4.5 million outpatient and emergency room visits annually corresponding to approximately 0.4 percent of all encounters. CAP is the second most common cause of hospitalization and the most common infectious cause of death. Approximately 650 adults are hospitalized with CAP every year per 100,000 population in the United States corresponding to 1.5 million unique CAP hospitalizations each year. 5 There are geographical differences in the microbial etiology of CAP and recent studies from the United States of America (USA) have suggested that respiratory viruses are the most common cause, followed by S. pneumoniae (pneumococcus). 6 Nevertheless the pneumococcus is still the cause of some 10- 15% of inpatient causes of CAP in the USA. 7 In other regions of the world such as Europe the pneumococcus remains the most common cause of CAP, with a considerable burden of disease. 8,9 It is now well recognized that cardiac complications occur commonly in patients with CAP particularly among hospitalized cases and include acute myocardial infarction (AMI), new or worsening arrhythmia Abstract Background: Community-acquired pneumonia (CAP) is the most frequent infectious disease, responsible for significant morbidity and mortality world wide. Poor outcome in CAP patients is directly related to pneumonia also to comorbidities both during hospitalization and long term after discharge. Objective: To determine the incidence of major cardiac complications in CAP patients. Materials and Methods: This observational study was conducted in Medicine Department, Gazi Medical College and Hospital (GMCAH) Khulna from January 2016 to March 2019. We studied patients with association of CAP and ACE on admission or Patients with CAP on admission, developing ACE after 48 to 72 hours of hospital stay. Patients who were admitted with ACE but developed a CAP after 48 to 72 hours of admission and Patients with severe sepsis with a concomitant elevated troponin were excluded from the study. Results: Out of 1406 patients with CAP, 12.4% presented with cardiovascular events and 87.6% without cardiovascular events. In cardiovascular events, 79.3% patient had heart failure, 17.8% had cardiac arrhythmia and 2.9% had myocardial infarction. Subjects with hyperlipidemia had 2.10 fold more cardiac events than subjects without hyperlipidemia. A Subject with (PSI) <80 vs >80 had 3.16 (95% CI 1.18 to 8.47) times increase in odds having cardiovascular events. Hyperlipidemia and PSI were significantly associated with cardiovascular events. Conclusion: Major cardiac complications occur in a substantial proportion of patients with CAP. Physicians and patients need to appreciate the significance of this association for timely recognition and management of these events. Strategies aimed at preventing pneumonia in high-risk population need to be optimized. Keywords: CAP, Cardivascular events,GMCH. Date of received: 18.06.2019. Date of acceptance: 25.11.2019. KYAMC Journal.2020;10(4): 191-195 . DOI: https://doi.org/10.3329/kyamcj.v10i4.45718 191