Timing of cardiovascular events in people with COPD with and without chronic respiratory failure

Chronic obstructive pulmonary disease (COPD) may be associated to comorbidities including cardiovascular diseases (CVD). The timing of CVD associated with chronic respiratory failure (CRF) in COPD people is unclear. This large, long-term, real life study is aimed to assess the timing of ischemic heart disease (IHD), congestive heart failure (CHF), and cardiac atrial arrhythmia (CAA) in COPD individuals with CRF as compared to those without.

This is a fifteen-year, retrospective matched (propensity score) observational cohort study (TriNetX Analytics Network) with two cohorts [Cohort 1: participants with coded (ICD-10-CM) COPD AND CRF diagnoses; Cohort 2: COPD people without CRF]. We estimated the 15-year CVD risk after the coded diagnoses. Using a Cox model, we compared incidences, hazard risks and probability to remain free from CVD.

Data of 123356 participants in each cohort, well matched for age, BMI and sex, were analyzed. The number of participants in each cohort was reduced for each CVD risk analysis by excluding those who had experienced the specific CVD event just prior to the study. After 15 years since coded diagnosis 38.5, 27.9, 57.6 % of participants in Cohort 1 were free from IHD, CHF, CAA as compared to 42.5, 43.5, 65.9 % (p < 0.0001) in Cohort 2.

With the limitations of the retrospective, observational nature of the study and of potential confounding factor, our results show that in individuals with COPD, CRF is associated with additional greater and earlier risks of cardiovascular diseases; targeted screening and monitoring in this population is desirable.