Baseline acute exacerbations of COPD independently predicted future major adverse cardiovascular events (aOR 6.43), with markedly increased risk within 30 days following onset (aHR 52.66).
Cohort (n=905)
Sí
Do baseline characteristics and acute exacerbations of COPD predict future major adverse cardiovascular events in patients with COPD?
Acute exacerbations of COPD and baseline cardiovascular comorbidities strongly predict the occurrence of major adverse cardiovascular events within the following year, highlighting the need for integrated cardiopulmonary care.
Estimación del efecto: aOR 6.43
Abstract Background Major adverse cardiovascular events (MACEs) significantly influence the prognosis and mortality of patients with chronic obstructive pulmonary disease (COPD). Acute exacerbations of COPD (AECOPDs) may precipitate MACEs, yet the contribution of baseline characteristics to future MACEs remains incomplete defined. Clarifying this association is essential for risk assessment and disease management. Methods This retrospective cohort study included 905 patients with COPD from 4 medical facilities. Baseline demographics and clinical characteristics were collected 1 year prior to the index date while MACEs were retrieved 1 year following the index date. Logistic regression was used to identify baseline predictors of MACEs. Time-dependent Cox regression models assessed cardiovascular risk following onset of AECOPD, stratified by exacerbation severity and time intervals. Results During one-year follow-up, 57 patients (6.3%) experienced MACEs (baseline characteristics were shown in Table A, events summery in Table B). In the overall population, baseline AECOPD (adjusted odds ratio aOR 6.43), coronary artery disease (aOR 5.95), and valvular heart disease (aOR 9.01) independently predicted MACEs, whereas inhaled triple therapy was protective compared with dual-bronchodilator therapy (aOR 0.13). Among patients without known cardiovascular disease (CVD) history, the presence of baseline AECOPD (aOR 12.83) and mMRC scale score ≥ 2 (aOR 4.41) were significantly predictive of MACEs, while diabetes mellitus (aOR 1.93, p = 0.05) tended to have an independent association (Table C). Time-dependent cox regression revealed markedly increased MACEs within 180 days following onset of AECOPD (adjusted hazard ratios aHRs of 52.66 for days 0-30 and 8.92 for days 31-180), particularly severe exacerbation (aHRs of 384.64 for days 0-30 and 21.68 for days 31-180, Figure D). Conclusion Our findings suggest a need for integrated care of cardiopulmonary health to mitigate future exacerbation and MACEs with a risk stratification strategy using vulnerable prognostic and protective factors as indicated in our analysis. This abstract is funded by: Taichung Veterans General Hospital (Grant No. TCVGH-1103203C) and Asia University Hospital (Grant No. 11351011 and 11351017)
Shen et al. (Fri,) conducted a cohort in Chronic obstructive pulmonary disease (COPD) (n=905). Baseline acute exacerbations of COPD (AECOPD) vs. No baseline AECOPD was evaluated on Major adverse cardiovascular events (MACEs) (aOR 6.43). Baseline acute exacerbations of COPD independently predicted future major adverse cardiovascular events (aOR 6.43), with markedly increased risk within 30 days following onset (aHR 52.66).
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