Major Cardiovascular Events in COPD Patients with pneumococcal infection. A nationwide self-controlled case series study.

<bold>Introduction:</bold> COPD patients are at increased risk of severe complications and death from community-acquired pneumonia, including Streptococcus pneumoniae. Previous studies suggest that acute infection raises the short-term risk of cardiovascular events. This study investigates the risk of major adverse cardiovascular events (MACE) during the acute phase of Streptococcus pneumoniae infection in COPD patients. Methods: We conducted a self-controlled case series study in COPD patients with a positive lower respiratory tract or blood culture for S. pneumoniae between 2010-2017 using Danish Nationwide register data. The primary outcome was the incidence of MACE, with the risk interval defined as the first 14 days after a positive culture for S. pneumoniae. The control interval was defined as 180 days before and after the risk interval. Statistical analysis involved conditional Poisson regression models to calculate incidence rate ratios. Results: We identified 327 patients with a positive culture for S. pneumoniae, of whom 60 died during the study period, leaving 267 for analysis. Pneumococcal infection was associated with a 4.6-fold increased incidence of MACE (p-value < 0.001) within 14 days. Acute myocardial infarction was increased by 9.1 (p-value < 0.001). <bold>Conclusion:</bold> Pneumococcal infection was associated with a significantly increased risk of MACE within 14 days postinfection in copd patients <fig><object-id>erj;66/suppl_69/PA4912/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>