Pseudomonas aeruginosa infection is linked to increases in cardiovascular events post exacerbation in bronchiectasis

Pseudomonas aeruginosa (PsA) infection contributes to disease progression in bronchiectasis (BE), particularly exacerbations which are known to increase the risk of cardiovascular (CV) events. However, the link between PsA infection and CV events in BE is unknown. Thus, we investigated whether there is an association between PsA airway infection and the risk of CV events post-exacerbation.

This was a US retrospective cohort study using the TriNetX platform between 2008 and 2019. Adult patients with (wPsA) or without (w/oPsA) PsA airway infection were included. Date of first exacerbation corresponded to the index date, and patients were followed for up to 5 years post index. Risk ratios (RR) for hospitalisation, subsequent exacerbation, mortality and incidence of pre-specified CV events were estimated. Propensity score matching (PSM) was used to balance baseline characteristics.

After PSM, patients wPsA infection were at a greater risk of hospitalisation (RR: 1.40; 95% CI: 1.19-1.64), subsequent exacerbation (RR: 1.70; 95% CI: 1.53-1.90) and mortality (RR: 1.37; 95% CI: 1.20-1.56) than patients w/oPsA. PsA infection was associated with a higher risk of dysrhythmias (RR: 1.32; 95% CI: 1.13-1.54), inflammatory heart disease (RR: 2.09; 95% CI: 1.29-3.37), other cardiac disorders (RR: 1.40; 95% CI: 1.14-1.72), thrombotic disorders (RR: 1.31; 95% CI: 1.01-1.68), major adverse cardiovascular events (RR: 1.35; 95% CI: 1.19-1.52) and any CV outcome (RR: 1.42; 95% CI: 1.24-1.62).

PsA infection in patients with BE is associated with an increased risk of CV events following a baseline exacerbation. These data highlight the multisystemic nature of BE and the need to raise awareness of the potential increased risk of CV events in patients with BE experiencing exacerbations.