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Prognostic value of serum angiotensin-converting enzyme activity for outcome of community-acquired pneumonia

  • Sabine C.A. Meijvis EMAIL logo , Marie Claire A. Cornips , Henrik Endeman , Henk J.T. Ruven , A.H. Jan Danser , Douwe H. Biesma , Hubert G.M. Leufkens , Willem Jan W. Bos and Ewoudt M.W. van de Garde
Published/Copyright: June 14, 2011
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Clinical Chemistry and Laboratory Medicine
From the journal Clinical Chemistry and Laboratory Medicine Volume 49 Issue 9

Abstract

Background: In a previous study, a relation between decreased serum angiotensin-converting enzyme (ACE) activity and physiological parameters was observed in patients with community-acquired pneumonia. The present study aims to further assess the prognostic value of serum ACE activity for outcome of community-acquired pneumonia.

Methods: This was a prospective observational study including two cohorts of patients with community-acquired pneumonia (2004–2006; n=157 and 2007–2010; n=138). Serum ACE activity was measured at time of hospital admission. Based on reference values in healthy persons, patients were divided into subgroups of serum ACE activity: normal, low and extremely low. Physiological parameters, clinical outcomes and etiology were compared between the subgroups.

Results: A total of 265 patients were enrolled in this study. Mean age was 60±19 years. In patients with low serum ACE activity (<20 U/L, n=53), compared to patients with normal serum ACE activity (≥20 U/L, n=212), C-reactive protein (CRP) was significantly increased, systolic blood pressure was significantly lower and there was a trend for higher heart rate and leukocyte counts. Furthermore, Streptococcus pneumoniae was significantly more identified in patients with low serum ACE activity. Serum ACE activity <24 U/L was independently associated with bacteremia (adjusted OR 3.93 [95% CI 1.57–9.87]). Low serum ACE activity was not prognostic for length of hospital stay nor mortality.

Conclusions: This study did not show prognostic value for serum ACE activity regarding clinical outcome in patients with community-acquired pneumonia. Serum ACE activity <24 U/L at time of hospitalization appeared an independent indicator for the presence of bacteremia. Further research should elucidate the role of ACE in systemic infection and sepsis during pneumonia.

Keywords: bacteremia; community-acquired pneumonia; serum angiotensin-converting enzyme activity; Streptococcus pneumoniae
Corresponding author: Sabine C.A. Meijvis, Department of Internal Medicine, St. Antonius Hospital, Postbus 2500, 3430 EM, Nieuwegein, The Netherlands Phone: +31 88 320 30 00, Fax: +31 30 609 29 99
Received: 2011-3-3
Accepted: 2011-5-1
Published Online: 2011-06-14
Published in Print: 2011-09-01

©2011 by Walter de Gruyter Berlin Boston

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https://doi.org/10.1515/CCLM.2011.626
Keywords for this article
bacteremia; community-acquired pneumonia; serum angiotensin-converting enzyme activity; Streptococcus pneumoniae

Articles in the same Issue

  1. Editorial
  2. Athlete's biological passport: to test or not to test?
  3. Review
  4. Prognostic value of cystatin C in acute coronary syndromes: enhancer of atherosclerosis and promising therapeutic target
  5. Opinion Papers
  6. The function of oxalic acid in the human metabolism
  7. Current limitations of the Athlete's Biological Passport use in sports
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