慢性阻塞性肺病恶化后心血管事件的风险:使用荷兰PHARMO数据网络进行EXACOS-CV队列研究的结果
Karin M A Swart1, Brenda N Baak2, Louise Lemmens2
1PHARMO Institute for Drug Outcomes Research, Utrecht, The Netherlands. pharmo@pharmo.nl.
Respiratory research
|November 22, 2023
概括
新诊断的慢性阻塞性肺病 (COPD) 患者面临严重心血管事件或恶化后死亡的风险明显更高. 这种风险在事件发生后的最初几天是最明显的.
科学领域:
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
- 流行病学 流行病学
背景情况:
- 慢性阻塞性肺病 (COPD) 与心血管 (CV) 事件风险增加有关,特别是在恶化后.
- 发生COPD患者在恶化后的CV负担尚未得到充分确立.
- 这项研究调查了中度或重度恶化后新诊断的COPD中严重的CV事件风险.
研究的目的:
- 评估COPD新诊断的患者发生严重心血管事件或死亡的风险.
- 在中度和/或重度COPD恶化后的时期量化这种风险.
主要方法:
- 分析了PHARMO数据网络中发生的COPD病例 (≥40年).
- 暴露时间: 1-7, 8-14, 15-30, 31-180天,以及恶化后的 181-365天.
- 中度恶化:门诊;严重恶化:住院. 综合结局:严重的心血管事件 (ACS,高血压,缺血,心律失常) 或死亡. 已经计算出了危险比率 (HR).
主要成果:
- 确诊了8020例COPD患者;28%的人患有恶化.
- 在36个月的中位数随访期间,复合结局发生在8% (CV事件) 和5% (死亡) 中.
- 复合结果的风险在恶化后显著增加 (HR范围:1.3-15.3).
- 在中度恶化后的180天内风险升高 (HR 1.6-2.5),在严重恶化后的一年内风险仍然很高 (HR 1.6-48.6).
结论:
- 发生COPD患者经历严重的CV事件或恶化后死亡的实质性增加.
- 在恶化后的立即时期观察到的最高风险.
- 这些发现强调了新诊断的COPD患者的显著心肺负担.
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