Laura C. Maclagan, Ruth Croxford, Anna Chu, Don D. Sin, Jacob A. Udell, Douglas S. Lee, Peter C. Austin, Andrea S. Gershon
European Respiratory Journal 2023; DOI: 10.1183/13993003.02364-2022
Abstract
Background Despite COPD being a risk factor for cardiovascular disease (CVD) and knowing that risk stratification for CVD primary prevention is important, little is known about the real world risk of CVD among people with COPD with no history of CVD. This knowledge would inform CVD management to people with COPD. The current study aimed to examine risk of major adverse cardiac events (MACE, including acute myocardial infarction, stroke or cardiovascular death) in a large, complete real-world population with COPD without previous CVD.
Methods We conducted a retrospective population cohort study using health administrative, medication, laboratory, electronic medical record and other data from Ontario, Canada. People without a history of CVD with and without physician diagnosed COPD were followed between 2008 and 2016 and cardiac risk factors and comorbidities compared. Sequential cause-specific hazard models adjusting for these factors determined the risk of MACE in people with COPD.
Results Among ∼5.8 million individuals in Ontario aged 40 years and older without CVD, 152 125 had COPD. After adjustment for cardiovascular risk factors, comorbidities and other variables, the rate of MACE was 25% higher in persons with compared to without COPD (HR=1.25, 95% CI [1.23, 1.27]).
Conclusions In a large real-world population without CVD, people with physician diagnosed COPD were 25% more likely to have a major CVD event, after adjustment for CVD risk and other factors. This rate is comparable to the rate in people with diabetes and calls for more aggressive CVD primary prevention in the COPD population.
Footnotes
This manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.
Conflict of interest statement: Dr. Sin reports having received small honorariums from GKS, AstraZeneca and Boehringer Ingelheim. Dr. Sin is Deputy Chief Editor of the European Respiratory Journal. Dr. Gershon is on the editorial board of the European Respiratory Journal
- Received December 7, 2022.
- Accepted June 15, 2023.
- Copyright ©The authors 2023. For reproduction rights and permissions contact permissions@ersnet.org
