Increased risk of severe cardiovascular events following exacerbations of COPD: A multi-database cohort study

01 Apr 2024
Introduction: Risk of severe cardiovascular events (CVE) increases following severe exacerbations of COPD (ECOPD). However, the duration of increased risk and the effect of moderate ECOPD are unclear. Objective: To quantify risk of a severe CVE or death following a moderate or severe ECOPD. Methods: Patients with COPD were identified in secondary databases between 2014–2018 in Canada, Germany, the Netherlands (NL) and Spain and followed until experiencing a composite outcome (death or hospitalisation for acute coronary syndrome, heart failure, arrhythmias or cerebral ischaemia) or censoring. Time-dependent Cox models compared the outcome risk incrementally over 12 months following an ECOPD (exposure) vs periods outside an ECOPD (non-exposure). Results: The proportions of patients with 1+ moderate and 1+ severe ECOPD were respectively 26.6% and 30.2% (Canada), 29.7% and 27.0% (Germany), 23.3% and 9.3% (NL), and 58.6% and 9.5% (Spain). Severe CVE or death occurred in 30.5% (Canada), 38.6% (Germany), 13.7% (NL) and 35.8% (Spain) of patients. In all countries, moderate ECOPD increased the risk of outcome for 1–6 months. Severe ECOPD further augmented risk, which was sustained for >12 months (Table). Conclusion: Patients experience elevated and sustained risk of a severe cardiopulmonary event or death following either moderate, or severe ECOPD, highlighting the urgency for comprehensive clinical management. Funding: AstraZeneca funded this study.

Resource information

Respiratory conditions
  • COPD
Respiratory topics
  • Co-morbidities
Type of resource
Abstract
Conference
Athens 2024
Author(s)
Claus F Vogelmeier 1, Sami O Simons 2, Edeltraut Garbe 3, Don D Sin 4, Nathaniel M Hawkins 5, Nicolas Manito 6, Salud Santos 7, Karin Polinder 8, Muriel Lobier 9, Paul Ekwaru 10, Nils Kossack 11, Ignacio Hernandez 12, Hana Mullerova 13, Arsh Randhawa 14, Lindy van Burk 15, Joaquin Sanchez-Covisa 16, Kirsty Rhodes 13, Clementine Nordon 13 1 Pulmonary and Critical Care Medicine, German Center for Lung Research (DZL), Philipps University of Marburg, Marburg, Germany, 2 NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands, 3 Department of Clinical Epidemiology, Leibniz Institute for Prevention Research and Epidemiology—BIPS, Bremen, Germany, 4 Centre for Heart Lung Innovation, University of British Columbia, Vancouver, Canada, 5 Centre for Cardiovascular Innovation, University of British Columbia, Vancouver, Canada, 6 Cardiology Service, Hospital Universitario de Bellvitge, Barcelona, Spain, 7 Department of Respiratory Medicine, Hospital Universitario de Bellvitge, Barcelona, Spain, 8 PHARMO Institute for Drug Outcomes Research, Utrecht, The Netherlands, 9 IQVIA, Espoo, Finland, 10 Medlior Health Outcomes Research Ltd, Calgary,, Canada, 11 WIG2 Institute, Leipzig, Germany, 12 Atrys Health, HEOR, Madrid, Spain, 13 AstraZeneca, Cambridge, United Kingdom, 14 AstraZeneca, Mississauga, Canada, 15 AstraZeneca, The Hague, The Netherlands, 16 AstraZeneca, Madrid, Spain