loading page

Corticosteroid use, myocardial injury and in-hospital cardiovascular events in patients with community-acquired pneumonia
  • +6
  • Roberto Cangemi,
  • Roberto Carnevale,
  • Vittoria Cammisotto,
  • Cristina Nocella,
  • Simona Bartimoccia,
  • Gloria Taliani,
  • Marco Falcone,
  • Pasquale Pignatelli,
  • Francesco Violi
Roberto Cangemi
Sapienza University of Rome

Corresponding Author:[email protected]

Author Profile
Roberto Carnevale
Sapienza University of Rome
Author Profile
Vittoria Cammisotto
Author Profile
Cristina Nocella
Sapienza University of Rome
Author Profile
Simona Bartimoccia
Author Profile
Gloria Taliani
Sapienza University of Rome
Author Profile
Marco Falcone
Pisa University Hospital
Author Profile
Pasquale Pignatelli
Sapienza University of Rome
Author Profile
Francesco Violi
Sapienza University of Rome
Author Profile


Background and Purpose: Patients with community acquired pneumonia (CAP) may suffer from myocardial injury, which is associated with increased risk of major adverse cardiovascular events (MACE). Corticosteroids are often prescribed to CAP patients, but the relationship between their use, myocardial injury and outcomes in these patients is unknown. Experimental Approach: 541 CAP patients were recruited (334 males; mean age: 71.9±16.2 years). High-sensitivity troponin T (hs-cTnT) was measured at admission, during the hospital stay and at discharge. MACE occurrence was registered during a long-term follow-up. Key Results: Overall, 318 patients (59%) showed hs-cTnT elevation > 99th percentile (>0.014 µg/L). Patients with hs-cTnT elevation were older, more likely to be former smokers, and with a higher prevalence of cardiovascular comorbidities. In a median follow-up of 22.7 months, a multivariable Cox proportional hazard regression analysis showed age, heart failure and the increasing quintiles of hs-cTnT (HR: 2.16; 95% CI: 1.82-2.58; p<0.001) predicted MACE. In-hospital corticosteroid use was found in 137 (25%) patients. Among patients with hs-cTnT >0.014 µg/L at admission, 102 patients (31%) were on corticosteroids and showed lower intra-hospital hs-cTnT increase compared to untreated ones (p=0.003). Among patients with hs-cTnT >0.014 µg/L, corticosteroid-treated patients showed a lower incidence of MACE than untreated ones [29% (27/99) vs. 43% (92/213); p value =0.042]; no effect of corticosteroids on MACE was observed in CAP patients with normal troponin. Conclusion and Implications: The study provides evidence that corticosteroid use is associated with lower increase of hs-cTnT and incidence of MACE in CAP patients.
10 Jul 2020Submitted to British Journal of Clinical Pharmacology
13 Jul 2020Submission Checks Completed
13 Jul 2020Assigned to Editor
27 Sep 2020Reviewer(s) Assigned
11 Feb 2021Review(s) Completed, Editorial Evaluation Pending
12 Feb 2021Editorial Decision: Revise Major
10 Apr 20211st Revision Received
20 Apr 2021Assigned to Editor
20 Apr 2021Submission Checks Completed
20 Apr 2021Review(s) Completed, Editorial Evaluation Pending
04 May 2021Reviewer(s) Assigned
13 May 2021Editorial Decision: Revise Major
24 May 20212nd Revision Received
25 May 2021Assigned to Editor
25 May 2021Submission Checks Completed
25 May 2021Review(s) Completed, Editorial Evaluation Pending
26 May 2021Editorial Decision: Accept
Jan 2022Published in British Journal of Clinical Pharmacology volume 88 issue 1 on pages 155-165. 10.1111/bcp.14936