Cardiovascular risk prediction using physical performance measures in COPD: results from a multicentre observational...

Area of Science:

• Cardiology
• Pulmonology
• Epidemiology

Background:

• Cardiovascular disease (CVD) is a common comorbidity in patients with chronic obstructive pulmonary disease (COPD).
• Traditional cardiovascular risk scores may not accurately predict CVD risk specifically in COPD populations.
• The utility of alternative markers for enhancing CVD risk prediction in COPD remains unclear.

Purpose of the Study:

• To evaluate the predictive value of conventional CVD risk factors in individuals with COPD.
• To determine if additional markers can improve CVD risk prediction beyond conventional factors in COPD patients.

Main Methods:

• Utilized data from the Evaluation of the Role of Inflammation in Chronic Airways disease cohort (n=714) with Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage II-IV COPD.
• Collected prospective data on hospitalizations and mortality over a median of 4.6 years.
• Assessed baseline markers including aortic pulse wave velocity (aPWV), carotid intima-media thickness (CIMT), C-reactive protein (CRP), fibrinogen, spirometry, Body mass index, airflow Obstruction, Dyspnoea and Exercise capacity (BODE) Index, 6-minute walk test (6MWT), and 4-meter gait speed (4MGS).

Main Results:

• Out of 714 participants, 27% experienced CV hospitalization, and 6 died from CVD.
• Conventional risk models had a C-statistic of 0.689; aPWV and CIMT did not improve prediction.
• CRP, fibrinogen, GOLD stage, BODE Index, 4MGS, and 6MWT were associated with outcomes (p<0.05), but only 6MWT improved model discrimination (C=0.727).

Conclusions:

• Poor physical performance, as measured by the 6-minute walk test (6MWT), enhances the prediction of cardiovascular hospitalisation in COPD patients.
• The 6MWT is a valuable tool for improving cardiovascular risk stratification in individuals with COPD.