COPD flares linked to adverse cardiovascular events

Patients with chronic obstructive pulmonary disorder (COPD) face a heightened risk of adverse cardiovascular events following moderate or severe exacerbations, according to a study.

For the study, researchers used administrative data from Alberta, Canada, and identified 142,787 COPD patients (mean age 68.1 years, 51.7 percent men). The primary outcome was the composite of all-cause death or a first hospitalization for acute coronary syndrome, heart failure, arrhythmia, or cerebral ischaemia.

Of the patients, 61,981 (43.4 percent) experienced at least one exacerbation event and 34,068 (23.9 percent) died over a median follow-up of 64 months. The primary outcome occurred in 43,564 (30.5 percent) patients.

The incidence rate of the primary outcome increased from 5.43 per 100 person-years (95 percent confidence interval [CI], 5.36–5.50) prior to exacerbation to 95.61 per 100 person-years in the 1–7 days after exacerbation (adjusted hazard ratio [HR], 15.86, 95 percent CI, 15.17–16.58). The risk of the primary outcome remained elevated for up to 1 year.

Of note, a moderate or severe COPD exacerbation was a risk factor for both the composite and individual CV events. However, the risk increase was greater and more prolonged following a severe exacerbation. The highest magnitude of increased risk was observed for heart failure decompensation (1–7 days: HR, 72.34, 95 percent CI, 64.43–81.22).

The findings underline the need to evaluate the impact of optimizing COPD management on cardiovascular outcomes.