Etiological Characteristics and Associated Factors in Older Patients with Coronary Heart Disease Complicated by Pulmonary Infection

Abstract

Background: Pulmonary infection is a common complication in older patients with coronary heart disease (CHD) and severely compromises their quality of life and prognosis. The distribution of pathogens in older patients with CHD complicated by pulmonary infection is complex, and increasing bacterial drug resistance poses a significant challenge to antibiotic therapy. Objectives: This study investigated pathogen types, antimicrobial susceptibility, and factors associated with pulmonary infection in older patients with CHD. Methods: Clinical data from 143 older patients with CHD complicated by pulmonary infection and 77 older patients without pulmonary infection were analyzed. Pathogen distribution was assessed in patients with pulmonary infection. Univariate and multivariate logistic regression analyses were performed to identify factors associated with pulmonary infection in older patients with CHD. Results: A total of 143 sputum specimens were collected from older patients with CHD complicated by pulmonary infection, yielding 152 pathogenic isolates. Univariate logistic regression analysis identified significant associations between pulmonary infection and a CHD history (≥ 5 years), comorbid chronic obstructive pulmonary disease (COPD), and procalcitonin (PCT) levels (all P < 0.05). Multivariate logistic regression analysis indicated that a CHD history (≥ 5 years), comorbid COPD, and PCT levels were associated with pulmonary infection in older patients with CHD (odds ratios = 2.377, 9.467, and 1.623, respectively; all P < 0.05). Conclusions: Antibiotics for older patients with CHD complicated by pulmonary infection should be selected on the basis of drug susceptibility test results. A CHD history (≥ 5 years), comorbid COPD, and PCT levels are associated with pulmonary infection in older patients with CHD.