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Chronic Obstructive Pulmonary Disease Exacerbations Increase the Risk of Subsequent Cardiovascular Events: A Longitudinal Analysis of the COPDGene Study

2024; Wiley; Volume: 13; Issue: 11 Linguagem: Inglês

10.1161/jaha.123.033882

2047-9980

Han‐Mo Yang, Min Hyung Ryu, Vincent J. Carey, Gregory L. Kinney, John E. Hokanson, Mark T. Dransfield, Craig P. Hersh, Edwin K. Silverman, James D. Crapo, Edwin K. Silverman, Barry J. Make, Elizabeth A. Regan, Terri H. Beaty, Peter J. Castaldi, Michael H. Cho, Dawn L. DeMeo, Adel Boueiz, Marilyn G. Foreman, Auyon Ghosh, Lystra P. Hayden, Craig P. Hersh, Jacqueline B. Hetmanski, Brian D. Hobbs, John E. Hokanson, Wonji Kim, Nan M. Laird, Christoph Lange, Sharon M. Lutz, Merry‐Lynn McDonald, Dmitry Prokopenko, Matthew Moll, Jarrett D. Morrow, Dandi Qiao, Elizabeth A. Regan, Aabida Saferali, Phuwanat Sakornsakolpat, Edwin K. Silverman, Emily S. Wan, Jeong H. Yun, Juan Pablo Centeno, Jean‐Paul Charbonnier, Harvey O. Coxson, Craig J. Galbán, MeiLan K. Han, Eric A. Hoffman, Stephen M. Humphries, Francine L. Jacobson, Philip F. Judy, Ella A. Kazerooni, Alex Kluiber, David A. Lynch, Pietro Nardelli, John D. Newell, Aleena Notary, Andrea Oh, Elizabeth A. Regan, James C. Ross, Raúl San Jośe Estépar, Joyce Schroeder, Jered Sieren, Berend C. Stoel, Juerg Tschirren, Edwin J.R. van Beek, Bram van Ginneken, Eva M. van Rikxoort, Gonzalo Vegas‐Sánchez‐Ferrero, Lucas Veitel, George R. Washko, Carla G. Wilson, Robert L. Jensen, Douglas Curran‐Everett, Jim Crooks, Katherine Pratte, Matthew Strand, Carla G. Wilson, John E. Hokanson, Erin Austin, Gregory L. Kinney, Sharon M. Lutz, Kendra A. Young, Surya P. Bhatt, Jessica Bon, Alejandro A. Díaz, MeiLan K. Han, Barry J. Make, Susan Murray, Elizabeth Regan, Xavier Soler, Carla G. Wilson, Russell P. Bowler, Katerina Kechris, Farnoush Banaei‐Kashani, Jeffrey L. Curtis, Perry G. Pernicano, Nicola A. Hanania, Mustafa Atik, Aladin M. Boriek, Kalpatha Guntupalli, Elizabeth Guy, Amit Parulekar, Dawn L. DeMeo, Craig P. Hersh, Francine L. Jacobson, George R. Washko, R. Graham Barr, John Austin, Belinda D’Souza, Byron Thomashow, Neil MacIntyre, H. Page McAdams, Lacey Washington, Charlene McEvoy, Joseph Tashjian, Robert A. Wise, Robert Brown, Nadia N. Hansel, Karen M. Horton, Allison Lambert, Nirupama Putcha, Richard Casaburi, Alessandra Adami, Matthew J. Budoff, H. Keith Fischer, János Pórszász, Harry B. Rossiter, William Stringer, Amir Sharafkhaneh, Charlie Lan, Christine Wendt, Brian Bell, Ken M. Kunisaki, Eric L. Flenaugh, Hirut Gebrekristos, Mario Castro, Silanath Terpenning, Gloria Westney, Russell Bowler, David A. Lynch, Richard Rosiello, David Pace, Gerard J. Criner, David Ciccolella, Francis Cordova, Chandra Dass, Gilbert E. D’Alonzo, Parag Desai, Michael R. Jacobs, Steven Kelsen, V. Kim, A. James Mamary, Nathaniel Marchetti, Aditi Satti, Kartik Shenoy, Robert M. Steiner, Alex Swift, Irene Swift, Maria Elena Vega‐Sanchez, Mark T. Dransfield, William R. Bailey, Surya P. Bhatt, Anand Iyer, Hrudaya Nath, J. Michael Wells, Douglas Conrad, Xavier Soler, Andrew Yen, Alejandro P. Comellas, Karin F. Hoth, John D. Newell, Brad Thompson, MeiLan K. Han, Ella A. Kazerooni, Wassim W. Labaki, Craig J. Galbán, Dharshan Vummidi, Joanne Billings, Abbie Begnaud, Tadashi Allen, Frank C. Sciurba, Jessica Bon, Divay Chandra, Joel L. Weissfeld, Antonio Anzueto, Sylvia Adams, Mario E. Ruiz, Harjinder Singh,

Asthma and respiratory diseases

Background Cardiovascular disease (CVD) is the most important comorbidity in patients with chronic obstructive pulmonary disease (COPD). COPD exacerbations not only contribute to COPD progression but may also elevate the risk of CVD. This study aimed to determine whether COPD exacerbations increase the risk of subsequent CVD events using up to 15 years of prospective longitudinal follow‐up data from the COPDGene (Genetic Epidemiology of Chronic Obstructive Pulmonary Disease) study. Methods and Results The COPDGene study is a large, multicenter, longitudinal investigation of COPD, including subjects at enrollment aged 45 to 80 years with a minimum of 10 pack‐years of smoking history. Cox proportional hazards models and Kaplan‐Meier survival curves were used to assess the risk of a composite end point of CVD based on the COPD exacerbation rate. Frequent exacerbators exhibited a higher cumulative incidence of composite CVD end points than infrequent exacerbators, irrespective of the presence of CVD at baseline. After adjusting for covariates, frequent exacerbators still maintained higher hazard ratios (HRs) than the infrequent exacerbator group (without CVD: HR, 1.81 [95% CI, 1.47–2.22]; with CVD: HR, 1.92 [95% CI, 1.51–2.44]). This observation remained consistently significant in moderate to severe COPD subjects and the preserved ratio impaired spirometry population. In the mild COPD population, frequent exacerbators showed a trend toward more CVD events. Conclusions COPD exacerbations are associated with an increased risk of subsequent cardiovascular events in subjects with and without preexisting CVD. Patients with COPD experiencing frequent exacerbations may necessitate careful monitoring and additional management for subsequent potential CVD. Registration URL: https://www.clinicaltrials.gov ; Unique identifier: NCT00608764.