B44-39 The Prognostic Value of Acute Cardiovascular Events in Hospitalized Patients for Chronic Obstructive Pulmonary Disease (COPD) Exacerbations

Abstract Rationale Cardiovascular disease (CVD) is a common comorbidity in patients with Chronic Obstructive Pulmonary Disease (COPD) and patients with COPD have increased probability of cardiovascular events. Acute exacerbations of COPD (AECOPD) are characterized by a systemic inflammatory response, creating a strong pathophysiological link between COPD and cardiovascular events. As a result, patients hospitalized for severe exacerbations are at increased risk of developing acute cardiovascular complications. However, the effect of an acute CVD event on the outcome of a COPD exacerbation is largely unknown. Objectives To compare patients who developed an acute cardiovascular event during hospitalization for severe AECOPD with those who did not, and to identify predictors associated with the occurrence of such events. Methods This multicenter, non-interventional, prospective study was conducted in seven pulmonary departments across Greece between September 2024 and September 2025. A total of 224 patients hospitalized for severe AECOPD were enrolled. CVD events were defined as acute coronary syndrome (acute myocardial infarction or unstable angina), decompensate heart failure, arrhythmia (atrial fibrillation, flutter, or other cardiac arrhythmias, including cardiac arrest), cerebral ischemia (ischemic stroke or transient ischemic attack), or fatal cardiovascular event, i.e., any cardiac event that led to death. Data collected included demographic and clinical characteristics, spirometry results, history of exacerbations and cardiovascular disease, and length of hospital stay. Multivariate analysis was performed to identify independent predictors of cardiovascular events. Results During hospitalization, 18.75% (n = 42) of patients experienced an acute cardiovascular event. Multivariate analysis demonstrated that advanced age (p = 0.005) and lower FEV1 values (p = 0.001) were independently associated with a higher risk of cardiovascular events. A history of frequent COPD exacerbations in the preceding year was also an independent risk factor (OR = 1.722, 95% CI 1.047-2.832). Conversely, a pre-existing cardiac history was not significantly associated with the occurrence of events (OR = 1.304, 95% CI 0.663-2.566). Patients who developed cardiovascular events had a significantly longer hospital stay compared with those who did not (10.1 ± 5.2 vs. 8.2 ± 4.83 days, p = 0.02). Conclusions Advanced age, reduced lung function (FEV1%), and a history of frequent exacerbations were independent predictors of acute cardiovascular events in patients hospitalized for severe AECOPD. The occurrence of such events adversely affected clinical outcomes by prolonging hospitalization. Early identification and proactive management of high-risk patients may help reduce cardiovascular complications and improve prognosis during COPD exacerbations. This abstract is funded by: None