{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T00:42:00Z","timestamp":1784767320174,"version":"3.55.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"15","license":[{"start":{"date-parts":[[2025,3,4]],"date-time":"2025-03-04T00:00:00Z","timestamp":1741046400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To assess the impact of antimicrobial resistance (AMR) on major adverse cardiovascular event (MACE) risk in patients with bronchiectasis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>This retrospective study utilized data from the TriNetX research network, analysing patients with bronchiectasis categorized by the presence or absence of AMR. Primary outcomes included the risk of MACE (myocardial infarction, stroke, and systemic thromboembolism, and cardiac arrest) and all-cause death. Cox regression analysis with 1:1 propensity score matching (PSM) was applied to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the primary outcomes. Subgroup analyses were conducted to validate results in clinically relevant subgroups. Prior to PSM, patients with AMR (n = 6543, 61.0 \u00b1 22.0 years, 55.8% female) were younger, more often male, and presented a higher prevalence of cardiovascular risk factors than those without AMR (n = 154 685, 67.3 \u00b1 16.0 years, 59.4% female). After PSM, no significant differences were found between groups. However, AMR patients showed a higher risk of MACE (HR 1.29, 95% CI 1.17\u20131.41) and all-cause death (HR 1.49, 95% CI 1.38\u20131.61) compared to non-AMR patients. The MACE risk was notably elevated among AMR patients without prior cardiovascular events (HR 1.56, 95% CI 1.34\u20131.81). Similar MACE risks were observed in cystic fibrosis (HR 1.24, 95% CI 0.86\u20131.78) and non-cystic fibrosis subgroups (HR 1.28, 95% CI 1.16\u20131.41), with consistent findings across different AMR types.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In patients with bronchiectasis, AMR is associated with an increased risk of MACE and all-cause death, suggesting that controlling AMR spread may confer broader health benefits, particularly in reducing cardiovascular risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurjpc\/zwaf122","type":"journal-article","created":{"date-parts":[[2025,3,2]],"date-time":"2025-03-02T15:14:31Z","timestamp":1740928471000},"page":"1427-1435","source":"Crossref","is-referenced-by-count":2,"title":["Risk of major cardiovascular events and all-cause death in patients with bronchiectasis and associated resistance to antimicrobial drugs"],"prefix":"10.1093","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2895-6234","authenticated-orcid":false,"given":"Tommaso","family":"Bucci","sequence":"first","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool and Heart and Chest Hospital , William Henry Duncan Building, 6 West Derby Street, Liverpool L7 8TX ,","place":["UK"]},{"name":"Department of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome , Piazzale Aldo Moro, 5, 00185 Rome, Italy ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ran","family":"Guo","sequence":"additional","affiliation":[{"name":"Cardiology Division, Department of Medicine, The University of Hong Kong , Hong Kong ,","place":["China"]},{"name":"Division of Cardiology, Department of Medicine, The University of Hong Kong Shen Zhen Hospital , Shen Zhen ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai-Hang","family":"Yiu","sequence":"additional","affiliation":[{"name":"Cardiology Division, Department of Medicine, The University of Hong Kong , Hong Kong ,","place":["China"]},{"name":"Division of Cardiology, Department of Medicine, The University of Hong Kong Shen Zhen Hospital , Shen Zhen ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory Y H","family":"Lip","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool and Heart and Chest Hospital , William Henry Duncan Building, 6 West Derby Street, Liverpool L7 8TX ,","place":["UK"]},{"name":"Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University , Fredrik Bajers Vej 7K, 9220 Aalborg \u00d8st ,","place":["Denmark"]},{"name":"Department of Cardiology, Lipidology and Internal Medicine, Medical University of Bialystok , Jana Kili\u0144skiego 1, 15-089 Bia\u0142ystok ,","place":["Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Freddy","family":"Frost","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool and Heart and Chest Hospital , William Henry Duncan Building, 6 West Derby Street, Liverpool L7 8TX ,","place":["UK"]},{"name":"Respiratory Department, Liverpool Heart & Chest Hospital NHS Foundation Trust , Liverpool ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,3,4]]},"reference":[{"key":"2025102719562204400_zwaf122-B1","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1016\/S2213-2600(18)30053-5","article-title":"Bronchiectasis: new therapies and new perspectives","volume":"6","author":"Chalmers","year":"2018","journal-title":"Lancet Respir Med"},{"key":"2025102719562204400_zwaf122-B2","doi-asserted-by":"crossref","first-page":"880","DOI":"10.1016\/S0140-6736(18)31767-7","article-title":"Advances in bronchiectasis: endotyping, genetics, microbiome, and disease heterogeneity","volume":"392","author":"Flume","year":"2018","journal-title":"Lancet"},{"key":"2025102719562204400_zwaf122-B3","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1136\/thoraxjnl-2015-208188","article-title":"Bronchiectasis and the risk of cardiovascular disease: a population-based study","volume":"72","author":"Navaratnam","year":"2017","journal-title":"Thorax"},{"key":"2025102719562204400_zwaf122-B4","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1016\/j.chest.2021.10.013","article-title":"Cardiovascular events during and after bronchiectasis exacerbations and long-term mortality","volume":"161","author":"Mendez","year":"2022","journal-title":"Chest"},{"key":"2025102719562204400_zwaf122-B5","doi-asserted-by":"crossref","first-page":"1193","DOI":"10.1001\/jama.2016.11764","article-title":"Antimicrobial resistance","volume":"316","author":"Marston","year":"2016","journal-title":"JAMA"},{"key":"2025102719562204400_zwaf122-B6","doi-asserted-by":"crossref","first-page":"1199","DOI":"10.1016\/S0140-6736(24)01867-1","article-title":"Global burden of bacterial antimicrobial resistance 1990\u20132021: a systematic analysis with forecasts to 2050","volume":"404","author":"Collaborators GBDAR","year":"2024","journal-title":"Lancet"},{"key":"2025102719562204400_zwaf122-B7","doi-asserted-by":"crossref","first-page":"100947","DOI":"10.1016\/j.lanmic.2024.07.010","article-title":"Antimicrobial resistance: a concise update","volume":"6","author":"Ho","year":"2024","journal-title":"Lancet Microbe"},{"key":"2025102719562204400_zwaf122-B8","author":"Prevention CfDCa"},{"key":"2025102719562204400_zwaf122-B9","volume-title":"State of the World\u2019s Antibiotics, 2015","author":"Gelband","year":"2015"},{"key":"2025102719562204400_zwaf122-B10","doi-asserted-by":"crossref","first-page":"e002104","DOI":"10.1136\/bmjgh-2019-002104","article-title":"Tackling antimicrobial resistance in low-income and middle-income countries","volume":"4","author":"Pokharel","year":"2019","journal-title":"BMJ Glob Health"},{"key":"2025102719562204400_zwaf122-B11"},{"key":"2025102719562204400_zwaf122-B12","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1016\/S0140-6736(21)02724-0","article-title":"Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis","volume":"399","author":"Antimicrobial Resistance C","year":"2022","journal-title":"Lancet"},{"key":"2025102719562204400_zwaf122-B13","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1016\/S2213-2600(24)00176-0","article-title":"Rethinking bronchiectasis as an inflammatory disease","volume":"12","author":"Long","year":"2024","journal-title":"Lancet Respir Med"},{"key":"2025102719562204400_zwaf122-B14","article-title":"Drug-resistant infections more likely to strike women, says WHO","author":"Wong","year":"2024","journal-title":"Nature"},{"key":"2025102719562204400_zwaf122-B15","doi-asserted-by":"crossref","first-page":"1582","DOI":"10.1161\/CIRCULATIONAHA.122.061183","article-title":"Severe infection and risk of cardiovascular disease: a multicohort study","volume":"147","author":"Sipila","year":"2023","journal-title":"Circulation"},{"key":"2025102719562204400_zwaf122-B16","doi-asserted-by":"crossref","first-page":"2949","DOI":"10.1089\/ars.2013.5766","article-title":"Is NOX2 upregulation implicated in myocardial injury in patients with pneumonia?","volume":"20","author":"Cangemi","year":"2014","journal-title":"Antioxid Redox Signal"},{"key":"2025102719562204400_zwaf122-B17","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1152\/physrev.00007.2009","article-title":"Sympathetic nervous system overactivity and its role in the development of cardiovascular disease","volume":"90","author":"Malpas","year":"2010","journal-title":"Physiol Rev"},{"key":"2025102719562204400_zwaf122-B18","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1016\/j.ejim.2016.09.008","article-title":"Impaired flow-mediated dilation in hospitalized patients with community-acquired pneumonia","volume":"36","author":"Loffredo","year":"2016","journal-title":"Eur J Intern Med"},{"key":"2025102719562204400_zwaf122-B19","doi-asserted-by":"crossref","first-page":"1917","DOI":"10.1016\/j.jacc.2014.07.985","article-title":"Platelet activation is associated with myocardial infarction in patients with pneumonia","volume":"64","author":"Cangemi","year":"2014","journal-title":"J Am Coll Cardiol"},{"key":"2025102719562204400_zwaf122-B20","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1016\/S0140-6736(12)61266-5","article-title":"Acute pneumonia and the cardiovascular system","volume":"381","author":"Corrales-Medina","year":"2013","journal-title":"Lancet"},{"key":"2025102719562204400_zwaf122-B21","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1038\/s41569-022-00737-2","article-title":"Gut-derived low-grade endotoxaemia, atherothrombosis and cardiovascular disease","volume":"20","author":"Violi","year":"2023","journal-title":"Nat Rev Cardiol"},{"key":"2025102719562204400_zwaf122-B22","doi-asserted-by":"crossref","first-page":"1209","DOI":"10.1183\/09031936.00081409","article-title":"Infection as a comorbidity of COPD","volume":"35","author":"Sethi","year":"2010","journal-title":"Eur Respir J"},{"key":"2025102719562204400_zwaf122-B23","first-page":"1436","article-title":"Risk of cardiovascular events according to the severity of an exacerbation of chronic obstructive pulmonary disease","volume":"32","author":"Zysman","year":"2025","journal-title":"Eur J Prev Cardiol"},{"key":"2025102719562204400_zwaf122-B24","doi-asserted-by":"crossref","first-page":"e032785","DOI":"10.1161\/JAHA.123.032785","article-title":"Risk of death and cardiovascular events in Asian patients with atrial fibrillation and chronic obstructive pulmonary disease: a report from the prospective APHRS registry","volume":"13","author":"Bucci","year":"2024","journal-title":"J Am Heart Assoc"},{"key":"2025102719562204400_zwaf122-B25","doi-asserted-by":"crossref","DOI":"10.1183\/13993003.00174-2023","article-title":"Prevalence, risk factors and outcomes of cardiac disease in cystic fibrosis: a multinational retrospective cohort study","volume":"62","author":"Frost","year":"2023","journal-title":"Eur Respir J"},{"key":"2025102719562204400_zwaf122-B26","doi-asserted-by":"crossref","first-page":"942","DOI":"10.1007\/s00392-024-02426-1","article-title":"Risk of death, thrombotic and hemorrhagic events in anticoagulated patients with atrial fibrillation and systemic autoimmune diseases: an analysis from a global federated dataset","volume":"113","author":"Bucci","year":"2024","journal-title":"Clin Res Cardiol"},{"key":"2025102719562204400_zwaf122-B27","doi-asserted-by":"crossref","first-page":"894","DOI":"10.1164\/rccm.202108-1889OC","article-title":"Characterization of eosinophilic bronchiectasis: a European multicohort study","volume":"205","author":"Shoemark","year":"2022","journal-title":"Am J Respir Crit Care Med"},{"key":"2025102719562204400_zwaf122-B28","doi-asserted-by":"crossref","first-page":"2127","DOI":"10.1056\/NEJMoa2021713","article-title":"Phase 2 trial of the DPP-1 inhibitor brensocatib in bronchiectasis","volume":"383","author":"Chalmers","year":"2020","journal-title":"N Engl J Med"},{"key":"2025102719562204400_zwaf122-B29","doi-asserted-by":"crossref","first-page":"1709","DOI":"10.1007\/s00011-023-01774-4","article-title":"BI 1291583: a novel selective inhibitor of cathepsin C with superior in vivo profile for the treatment of bronchiectasis","volume":"72","author":"Kreideweiss","year":"2023","journal-title":"Inflamm Res"},{"key":"2025102719562204400_zwaf122-B30","doi-asserted-by":"crossref","first-page":"2936","DOI":"10.1093\/eurheartj\/ehu131","article-title":"Competing risks analyses: objectives and approaches","volume":"35","author":"Wolbers","year":"2014","journal-title":"Eur Heart J"}],"container-title":["European Journal of Preventive Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/eurjpc\/advance-article-pdf\/doi\/10.1093\/eurjpc\/zwaf122\/62266452\/zwaf122.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eurjpc\/advance-article-pdf\/doi\/10.1093\/eurjpc\/zwaf122\/62266452\/zwaf122.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eurjpc\/advance-article-pdf\/doi\/10.1093\/eurjpc\/zwaf122\/62266452\/zwaf122.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T23:56:31Z","timestamp":1761609391000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eurjpc\/article\/32\/15\/1427\/8051876"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,4]]},"references-count":30,"journal-issue":{"issue":"15","published-online":{"date-parts":[[2025,3,4]]},"published-print":{"date-parts":[[2025,10,28]]}},"URL":"https:\/\/doi.org\/10.1093\/eurjpc\/zwaf122","relation":{},"ISSN":["2047-4873","2047-4881"],"issn-type":[{"value":"2047-4873","type":"print"},{"value":"2047-4881","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,10]]},"published":{"date-parts":[[2025,3,4]]}}}