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- Title
Prognostic value of serum angiotensin-converting enzyme activity for outcome of community-acquired pneumonia.
- Authors
Meijvis, Sabine C.A.; Cornips, Marie Claire A.; Endeman, Henrik; Ruven, Henk J.T.; Jan Danser, A.H.; Biesma, Douwe H.; Leufkens, Hubert G.M.; Bos, Willem Jan W.; van de Garde, Ewoudt M.W.
- Abstract
Background: In a previous study, a relation between decreased serum angiotensin-converting enzyme (ACE) activity and physiological parameters was observed in patients with community-acquired pneumonia. The present study aims to further assess the prognostic value of serum ACE activity for outcome of community-acquired pneumonia. Methods: This was a prospective observational study including two cohorts of patients with community-acquired pneumonia (2004-2006; n=157 and 2007-2010; n=138). Serum ACE activity was measured at time of hospital admission. Based on reference values in healthy persons, patients were divided into subgroups of serum ACE activity: normal, low and extremely low. Physiological parameters, clinical outcomes and etiology were compared between the subgroups. Results: A total of 265 patients were enrolled in this study. Mean age was 60±19 years. In patients with low serum ACE activity (<20 U/L, n=53), compared to patients with normal serum ACE activity (≥20 U/L, n=212), C-reactive protein (CRP) was significantly increased, systolic blood pressure was significantly lower and there was a trend for higher heart rate and leukocyte counts. Furthermore, Streptococcus pneumoniae was significantly more identified in patients with low serum ACE activity. Serum ACE activity <24 U/L was independently associated with bacteremia (adjusted OR 3.93 [95% CI 1.57-9.87]). Low serum ACE activity was not prognostic for length of hospital stay nor mortality. Conclusions: This study did not show prognostic value for serum ACE activity regarding clinical outcome in patients with community-acquired pneumonia. Serum ACE activity <24 U/L at time of hospitalization appeared an independent indicator for the presence of bacteremia. Further research should elucidate the role of ACE in systemic infection and sepsis during pneumonia.
- Subjects
ANGIOTENSIN converting enzyme; COMMUNITY-acquired pneumonia; C-reactive protein; STREPTOCOCCUS pneumoniae; BLOOD pressure; HEART beat; PROGNOSIS; DIAGNOSIS
- Publication
Clinical Chemistry & Laboratory Medicine, 2011, Vol 49, Issue 9, p1525
- ISSN
1434-6621
- Publication type
Article
- DOI
10.1515/CCLM.2011.626