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October 2015, Vol 148, No.


Chest Infections | October 2015

Calcium Channel Blockers and Outcomes in

Lin Zheng, MD; Sameer Poddar, MD
Cooper Medical School of Rowan University, Camden, NJ

Chest. 2015;148(4_MeetingAbstracts):120A. doi:10.1378/chest.2257215

SESSION TITLE: Chest Infections Posters I

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: Calcium channel blockers(CCBs) have been shown to decrease overall mortality in septic animal
models. However, to our best knowledge, no study had been conducted in human subjects to asses their impact in
sepsis. Here we investigated the potential protective effect of pre-hospital CCB use against severe sepsis in patients
with pneumonia.

METHODS: Retrospective study of hospitalized patients with diagnosis code of 481, 482, 485 or 486 from the year
of 2012 to 2014. Patient data were extracted from the EPIC electronic database.Chest radiography and clinical
presentation were reviewed for the presence of clinically compatible pneumonia at the first 72 hours of admission.
Certain inclusion and exclusion criteria were applied. Continuous outcomes were analyzed by multivariate analysis of
variance and dichotomous outcomes by logistic regression.

RESULTS: RESULTS: Total 2214 patients were admitted with pneumonia during this period of time. Among total
2214 patients, 1230 patients were included into the study, of which included 373 CCB users and 857 non-CCB users.
After adjusting age, gender, statin use and Charleston Comorbidity Index (CCI), our study revealed CCB use was
associated with less severity of disease on arrival by pneumonia severity scores(Standardized Coefficients β(β) of -
0.135, p<0.05). Meanwhile, there was a significant difference in the Length of Stay (LOS) between CCB group and
non-CCB group (β -0.119, p<0.05). Moreover, CCB use was associated with less chance to be admitted to Intensive
Care Unit (p: 0.029) for the whole hospital stay. Regarding the outcomes, CCB use seems to have no association
with the development of acute renal failure and in-hospital mortality (p>0.05). However, it is associated with less
respiratory failure needing high flow oxygen (p: 0.008), less bacteremia (p<0.037) as well as less chances of
developing severe sepsis or septic shock (p: 0.001).

CONCLUSIONS: Pre-hospital CCB use is inversely associated with the development of respiratory failure,
bacteremia and severe sepsis in patients with pneumonia.

CLINICAL IMPLICATIONS: Pneumonia is one of leading causes for hospital admission, sepsis and death. CCBs
have been shown to be beneficial in animal sepsis syndrome models as an immunomodulator. As the first study to
asses the beneficial effect(s) of CCBs in severe infections in human subjects, our study adds to the accumulating
evidences from animal studies that CCB use is associated with better outcomes in severe infections like pneumonia.

DISCLOSURE: The following authors have nothing to disclose: Lin Zheng, Sameer Poddar

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