{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T12:44:49Z","timestamp":1776689089077,"version":"3.51.2"},"reference-count":33,"publisher":"BMJ","issue":"11","license":[{"start":{"date-parts":[[2025,11,9]],"date-time":"2025-11-09T00:00:00Z","timestamp":1762646400000},"content-version":"unspecified","delay-in-days":8,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Pfizer, Inc."}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,9,29]]},"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We aimed to assess the risk of cardiovascular hospitalisations (stroke or myocardial infarction (MI)) following a community-acquired pneumonia (CAP) hospitalisation in a large Portuguese administrative dataset.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Self-controlled case series study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>We used hospitalisation data from National Health Service hospitals across Portugal between 2010 and 2018.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Adults hospitalised for both CAP and stroke\/MI in Portugal during the 2010-2018 period (n=13 494, of which 10 400 with stroke and 3094 with MI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>We considered CAP hospitalisation as the exposure (14-, 28- and 91-day exposure periods) and acute cardiovascular (stroke or MI) hospitalisations as the outcome. Incidence rate ratios (IRR) were computed using a conditional Poisson regression (overall and by sex and age subgroups).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Patients were mostly male and above 75 years. Stroke\/MI hospitalisation incidence was higher following CAP, compared with the baseline period. Largest differences were observed in the 14-day period after discharge (IRR for stroke: 2.55, 95% CI: 2.33\u20132.80; IRR for MI: 3.23, 2.78\u20133.75), compared with the 28-day (IRR for stroke: 2.06, 1.92\u20132.22; IRR for MI: 2.62, 2.32\u20132.95) and 91-day periods (IRR for stroke: 1.37, 1.30\u20131.44; IRR for MI: 1.75, 1.60\u20131.91). A similar trend was observed for sex and age subgroups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our study shows an increased risk of stroke\/MI for CAP patients, particularly during the first 2 weeks after being discharged. Effective postdischarge monitoring and follow-up, combined with efforts to prevent CAP occurrence, could improve patient outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-101068","type":"journal-article","created":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T05:45:25Z","timestamp":1762753525000},"page":"e101068","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Risk of stroke or myocardial infarction hospitalisation following hospitalisation for community-acquired pneumonia in Portugal: a self-controlled case series study"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8140-5004","authenticated-orcid":false,"given":"Joana","family":"Carneiro","sequence":"first","affiliation":[{"name":"NOVA University Lisbon National School of Public Health, Lisbon, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0843-0630","authenticated-orcid":false,"given":"Andreia","family":"Leite","sequence":"additional","affiliation":[{"name":"Public Health Research Centre, Comprehensive Health Research Center, CHRC, REAL, CCAL, NOVA University Lisbon National School of Public Health, Lisbon, Portugal"},{"name":"Department of Epidemiology, National Institute of Health Doctor Ricardo Jorge, Lisbon, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9748-9273","authenticated-orcid":false,"given":"Maria","family":"Lahuerta","sequence":"additional","affiliation":[{"name":"Pfizer Inc, Collegeville, Pennsylvania, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4367-995X","authenticated-orcid":false,"given":"Julie","family":"Catusse","sequence":"additional","affiliation":[{"name":"Pfizer Inc, Collegeville, Pennsylvania, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1410-388X","authenticated-orcid":false,"given":"Mohammad","family":"Ali","sequence":"additional","affiliation":[{"name":"Pfizer Inc, Collegeville, Pennsylvania, USA"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-3338-4892","authenticated-orcid":false,"given":"Rita","family":"Teixeira","sequence":"additional","affiliation":[{"name":"Pfizer Inc, Collegeville, Pennsylvania, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6048-396X","authenticated-orcid":false,"given":"Silvia","family":"Lopes","sequence":"additional","affiliation":[{"name":"Public Health Research Centre, Comprehensive Health Research Center, CHRC, REAL, CCAL, NOVA University Lisbon National School of Public Health, Lisbon, Portugal"}]}],"member":"239","published-online":{"date-parts":[[2025,11,9]]},"reference":[{"key":"2025120413262759000_15.11.e101068.1","unstructured":"Cardiovascular diseases. 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