Chronic bronchial infection predicts inflammation, higher CV events in COPD

Chronic bronchial infection (CBI), particularly by Pseudomonas aeruginosa (PA), may result in sustained and enhanced systemic inflammation, as well as higher incidence of cardiovascular (CV) events in patients with chronic obstructive pulmonary disease (COPD), results of a study have shown.

The authors conducted a post hoc analysis of prospectively collected cohort of 201 COPD patients (Global Initiative for Chronic Obstructive Lung Disease [GOLD] II–IV), followed up every 3–6 months for 84 months, to examine the association between CBI, systemic inflammation, and incident CV events.

CBI was defined as three or more positive pathogenic microorganism sputum cultures over 1 year, separated by ≥3 months. The authors prospectively recorded fatal and nonfatal CV events, including coronary and cerebrovascular events as well as arrhythmia episodes. These events were analysed separately and combined in a composite variable.

CBI correlated with persistent systemic inflammation and a markedly increased incidence of CV events (hazard ratio [HR], 3.8, 95 percent confidence interval [CI], 1.83–8.22), primarily of coronary origin independent of age, number and severity of exacerbations, comorbidities, other CV risk factors, lung function, body mass index, smoking status, and treatments.

Of note, such associations were more robust in patients with CBI by PA.

“The possibility that treating CBI may decrease systemic inflammation and CV events in COPD deserves prospective, interventional studies,” the authors said.

CV diseases and CBI are common in COPD patients, with the latter associating with systemic inflammation, a well-known CV risk factor.