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No association between exacerbation frequency and stroke in patients with COPD
Claire Windsor1, Emily Herrett1, Liam Smeeth1
1Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
International Journal of Chronic Obstructive Pulmonary Disease
|February 20, 2016
Summary
Frequent exacerbations in chronic obstructive pulmonary disease (COPD) did not increase stroke risk. However, higher exacerbation frequency was linked to a decreased risk of hemorrhagic stroke in COPD patients.
Area of Science:
- Pulmonary Medicine
- Neurology
- Epidemiology
Background:
- Patients with chronic obstructive pulmonary disease (COPD) face a higher stroke risk than the general population.
- Chronic inflammation in COPD is a suspected contributor to this elevated risk.
- COPD exacerbations, marked by increased inflammation, may influence stroke risk.
Purpose of the Study:
- To investigate the association between the frequency of COPD exacerbations and the risk of stroke.
- To determine if frequent exacerbators (FEs) have a higher stroke risk compared to infrequent exacerbators (IEs).
Main Methods:
- A case-control study using the UK Clinical Practice Research Datalink.
- Matched 6,441 COPD patients with a first stroke (cases) to 19,323 COPD patients without stroke (controls).
- Defined FEs as ≥2 exacerbations and IEs as ≤1 exacerbation in the year preceding the event; analyzed stroke subtypes.
Main Results:
- No significant difference in stroke odds was found between FEs and IEs (OR=0.95).
- A significant trend showed decreased stroke risk with increased annual exacerbations (P=0.003).
- Frequent exacerbators had significantly lower odds of hemorrhagic stroke (OR=0.67).
Conclusions:
- COPD exacerbation frequency does not appear to be the primary driver of increased stroke risk in COPD patients.
- Further research is warranted to explore stroke risk in relation to exacerbation severity, duration, and treatment, alongside cardiovascular risk management.
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