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Chronic Obstructive Pulmonary Disease as a Predictor of Cardiovascular Risk: A Case-Control Study.
Mohammed Y Khanji1,2, Ian S Stone1,2, Redha Boubertakh1,2
1Centre for Advanced Cardiovascular Imaging, NIHR Barts Biomedical Research Centre, William Harvey Research Institute, Queen Mary University London, London, UK.
COPD
|December 14, 2019
Summary
Chronic obstructive pulmonary disease (COPD) adversely affects arterial stiffness, increasing cardiovascular event risk. Incorporating COPD into risk models may improve prediction for better patient management.
Area of Science:
- Cardiology
- Pulmonology
- Medical Research
Background:
- Chronic obstructive pulmonary disease (COPD) is linked to increased cardiac mortality.
- Current cardiovascular risk prediction models do not account for COPD.
- COPD's impact on cardiovascular risk requires further investigation.
Purpose of the Study:
- To investigate if COPD modifies future cardiovascular risk.
- To determine if COPD should be included in cardiovascular risk prediction models.
Main Methods:
- A case-control study utilizing data from two randomized controlled trials (2012-2015).
- Propensity matching of 26 COPD patients with lung hyperinflation to 26 controls based on 10-year global cardiovascular risk score (QRISK2).
- Measurements included cardiac MRI, arterial stiffness (pulse wave velocity, total arterial compliance, aortic distensibility), and lung function.
Main Results:
- COPD patients exhibited significantly higher pulse wave velocity (PWV) and lower total arterial compliance (TAC) compared to controls.
- The observed PWV difference suggests a 14-15% increase in relative risk for cardiovascular events and mortality.
- QRISK2 and PWV relationship was modified by COPD, indicating an interaction effect.
Conclusions:
- Cardiovascular outcome markers are negatively impacted in COPD patients with lung hyperinflation.
- Cardiovascular risk algorithms could be enhanced by including a COPD variable for improved risk prediction.
- This inclusion may aid in guiding management strategies for COPD patients.
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