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Cardiovascular Prognosis of Subclinical Chronic Obstructive Pulmonary Disease in Patients with Suspected or Confirmed
Eduardo José Pereira Ferreira1,2,3,4, Lucas Villar Shan de Carvalho Cardoso3,5, Carlos José Oliveira de Matos6
1Department of Medicine, Federal University of Sergipe, Lagarto, 49400-000, Brazil.
Insights
Patients with early chronic obstructive pulmonary disease (COPD) and coronary artery disease (CAD) face higher risks of adverse cardiovascular events. COPD independently predicts these events, even in mild cases, highlighting the need for integrated management.
Area of Science:
- Cardiology
- Pulmonology
- Public Health
Background:
- Chronic obstructive pulmonary disease (COPD) is known to worsen outcomes in patients with coronary artery disease (CAD).
- The cardiovascular prognosis for patients with stable or early-stage COPD and concurrent CAD is not well-defined.
- This study investigates long-term cardiovascular events in patients with subclinical or early COPD and CAD.
Purpose of the Study:
- To determine the long-term cardiovascular event rates in patients with subclinical or early-stage COPD and concomitant CAD.
- To assess whether COPD is an independent predictor of cardiovascular events in this population.
Main Methods:
- A longitudinal analytical study followed 117 patients with suspected or established CAD for six years.
- Patients were stratified into COPD (n=44) and non-COPD (n=73) groups based on spirometry.
- Cox regression analysis was employed to evaluate the association between COPD and cardiovascular events, adjusting for CAD risk factors.
Main Results:
- COPD patients were older, more frequently had diabetes, were more likely to smoke, and reported higher dyspnea scores.
- COPD patients exhibited significantly higher CAD frequency and severity (severe and multivessel disease).
- At six-year follow-up, COPD patients had a significantly higher incidence of adverse cardiovascular events (effect size, 0.720). COPD remained an independent predictor (OR: 5.13; 95% CI: 2.29-11.50).
Conclusions:
- COPD is associated with increased coronary lesion severity and a higher number of adverse cardiovascular events in patients with CAD.
- COPD is a significant independent predictor of long-term cardiovascular events in patients with stable, subclinical, or early-stage COPD and CAD.
Background:
Chronic obstructive pulmonary disease (COPD) worsens prognosis in patients with coronary artery disease (CAD). However, the cardiovascular prognosis in patients with stable or mildly symptomatic COPD remains unclear. Here, we sought to determine the long-term cardiovascular events in patients with subclinical or early-stage COPD with concomitant CAD.
Methods:
This was a longitudinal analytical study involving 117 patients with suspected or established CAD who underwent assessment of pulmonary function by spirometry and who were followed up for six years (March 2015-January 2021). The patients were divided into two groups, one comprising COPD (n=44) and the other non-COPD (n=73) patients. Cox regression was used to evaluate the association between COPD and cardiovascular events, with adjustment for the established CAD risk factors, and the effect size was measured by the Cohen test.
Results:
COPD patients were older (p=0.028), had a greater frequency of diabetes (p=0.026), were more likely to be smokers (p<0.001), and had higher modified Medical Research Council scores (p<0.001). There was no difference between the groups regarding gender, body mass index, hypertension, dyslipidemia, family history of CAD, and type of angina. CAD frequency and the proportion of patients with severe and multivessel CAD were significantly higher among COPD than among non-COPD patients (all p<0.001). At six-year follow-up, patients with COPD were more likely to have experienced adverse cardiovascular events than those without COPD (p<0.001; effect size, 0.720). After adjusting for established CAD risk factors, COPD occurrence remained an independent predictor for long-term adverse cardiovascular events (OR: 5.13; 95% CI: 2.29-11.50; p<0.0001).
Conclusion:
COPD was associated with increased severity of coronary lesions and a greater number of adverse cardiovascular events in patients with suspected or confirmed CAD. COPD remained a predictor of long-term cardiovascular events in stable patients with subclinical or early-stage of COPD, independently of the established CAD risk factors.
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