{Reference Type}: Journal Article
{Title}: Risk of severe cardiovascular events following COPD exacerbations: results from the EXACOS-CV study in Spain.
{Author}: Santos S;Manito N;Sánchez-Covisa J;Hernández I;Corregidor C;Escudero L;Rhodes K;Nordon C;
{Journal}: Rev Esp Cardiol (Engl Ed)
{Volume}: 0
{Issue}: 0
{Year}: 2024 Jun 25
暂无{DOI}: 10.1016/j.rec.2024.06.003
{Abstract}: <B>OBJECTIVE: </B>This real-world study-the first of its kind in a Spanish population-aimed to explore severe risk for cardiovascular events and all-cause death following exacerbations in a large cohort of patients with chronic obstructive pulmonary disease (COPD).<BR><B>METHODS: </B>We included individuals with a COPD diagnosis code between 2014 and 2018 from the BIG-PAC health care claims database. The primary outcome was a composite of a first severe cardiovascular event (acute coronary syndrome, heart failure decompensation, cerebral ischemia, arrhythmia) or all-cause death following inclusion in the cohort. Time-dependent Cox proportional hazards models estimated HRs for associations between exposed time periods (1-7, 8-14, 15-30, 31-180, 181-365, and >365 days) following an exacerbation of any severity, and following moderate or severe exacerbations separately (vs unexposed time before a first exacerbation following cohort inclusion).<BR><B>RESULTS: </B>During a median follow-up of 3.03 years, 18 901 of 24 393 patients (77.5%) experienced ≥ 1 moderate/severe exacerbation, and 8741 (35.8%) experienced the primary outcome. The risk of a severe cardiovascular event increased following moderate/severe COPD exacerbation onset vs the unexposed period, with rates being most increased during the first 1 to 7 days following exacerbation onset (HR, 10.10; 95%CI, 9.29-10.97) and remaining increased >365 days after exacerbation onset (HR, 1.65; 95%CI, 1.49-1.82).<BR><B>CONCLUSIONS: </B>The risk of severe cardiovascular events or death increased following moderate/severe exacerbation onset, illustrating the need for proactive multidisciplinary care of patients with COPD to prevent exacerbations and address other cardiovascular risk factors.