{"id":"1c7beb1637d4","type":"article","url":"https://hartvaat.nl/2021/04/27/pneumonie-incidentie-en-uitkomsten-bij-hartfalen/","title":"Pneumonie-incidentie en uitkomsten bij hartfalen","title_en":"Incidence and Outcomes of Pneumonia in Patients With Heart Failure.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog"],"tags":[],"journal":"Journal of the American College of Cardiology","doi":"10.1016/j.jacc.2021.03.001","source_url":"https://doi.org/10.1016/j.jacc.2021.03.001","authors":["Li Shen","Pardeep S Jhund","Inder S Anand","Ankeet S Bhatt","Akshay S Desai","Aldo P Maggioni","Felipe A Martinez","Marc A Pfeffer","Adel R Rizkala","Jean L Rouleau","Karl Swedberg","Muthiah Vaduganathan","Orly Vardeny","Dirk J van Veldhuisen","Faiez Zannad","Michael R Zile","Milton Packer","Scott D Solomon","John J V McMurray"],"significance":5,"published":"2021-04-27","source_date":"2021-04-27","image":"","kennis":[],"congress":"","summary_en":"This study showed that pneumonia incidence and outcomes differ between HFrEF and HFpEF patients, highlighting the infection vulnerability of heart failure and the need for vaccination and prevention strategies.","created":"2026-07-03T10:29:09Z","updated":"2026-07-03T13:28:17Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Studie naar de incidentie en uitkomsten van pneumonie bij hartfalenpatiënten.","abstract_original":"BACKGROUND: The incidence of pneumonia and subsequent outcomes has not been compared in patients with heart failure and reduced ejection fraction (HFrEF) and preserved ejection fraction (HFpEF). OBJECTIVES: This study aimed to examine the rate and impact of pneumonia in the PARADIGM-HF (Prospective Comparison of Angiotensin Receptor-Neprilysin Inhibitor With Angiotensin Converting Enzyme Inhibitor to Determine Impact on Global Mortality and Morbidity in Heart Failure) and PARAGON-HF (Prospective Comparison of ARNI with ARB Global Outcomes in Heart Failure with Preserved Ejection Fraction) trials. METHODS: The authors analyzed the incidence of investigator-reported pneumonia and the rates of HF hospitalization, cardiovascular death, and all-cause death before and after the occurrence of pneumonia, and estimated risk after the first occurrence of pneumonia in unadjusted and adjusted analyses (the latter including N-terminal pro-B-type natriuretic peptide). RESULTS: In PARADIGM-HF, 528 patients (6.3%) developed pneumonia after randomization, giving an incidence rate of 29 (95% CI: 27 to 32) per 1,000 patient-years. In PARAGON-HF, 510 patients (10.6%) developed pneumonia, giving an incidence rate of 39 (95% CI: 36 to 42) per 1,000 patient-years. The subsequent risk of all trial outcomes was elevated after the occurrence of pneumonia. In PARADIGM-HF, the adjusted hazard ratio (HR) for the risk of death from any cause was 4.34 (95% CI: 3.73 to 5.05). The corresponding adjusted HR in PARAGON-HF was 3.76 (95% CI: 3.09 to 4.58). CONCLUSIONS: The incidence of pneumonia was high in patients with HF, especially HFpEF, at around 3 times the expected rate. A first episode of pneumonia was associated with 4-fold higher mortality. (Prospective Comparison of Angiotensin Receptor-Neprilysin Inhibitor With Angiotensin-Converting Enzyme Inhibitor to Determine Impact on Global Mortality and Morbidity in Heart Failure [PARADIGM-HF], NCT01035255; Prospective Comparison of ARNI [Angiotensin Receptor-Neprilysin Inhibitor] With ARB [Angiotensin Receptor Blocker] Global Outcomes in Heart Failure With Preserved Ejection Fraction [PARAGON-HF], NCT01920711)."}