Quantifying COPD as a risk factor for cardiac disease in a primary prevention cohort.

Autor:	Maclagan LC; ICES, Toronto, ON, Canada., Croxford R; ICES, Toronto, ON, Canada., Chu A; ICES, Toronto, ON, Canada., Sin DD; Centre for Heart Lung Innovation, St Paul's Hospital and Division of Respiratory Medicine, The University of British Columbia, Vancouver, BC, Canada., Udell JA; ICES, Toronto, ON, Canada.; Cardiovascular Division, Department of Medicine, Women's College Hospital and Women's College Research Institute, Toronto, ON, Canada.; Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada.; Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada.; Department of Medicine, University of Toronto, Toronto, ON, Canada., Lee DS; ICES, Toronto, ON, Canada.; Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada.; Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada.; Department of Medicine, University of Toronto, Toronto, ON, Canada., Austin PC; ICES, Toronto, ON, Canada.; Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada., Gershon AS; ICES, Toronto, ON, Canada andrea.gershon@sunnybrook.ca.; Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada.; Department of Medicine, University of Toronto, Toronto, ON, Canada.; Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Jazyk:	angličtina
Zdroj:	The European respiratory journal [Eur Respir J] 2023 Aug 31; Vol. 62 (2). Date of Electronic Publication: 2023 Aug 31 (Print Publication: 2023).
DOI:	10.1183/13993003.02364-2022
Abstrakt:	Background: Despite COPD being a risk factor for cardiovascular disease (CVD) and knowing that risk stratification for CVD primary prevention is important, little is known about the real-world risk of CVD among people with COPD with no history of CVD. This knowledge would inform CVD management for people with COPD. The current study aimed to examine the risk of major adverse cardiovascular events (MACE) (including acute myocardial infarction, stroke or cardiovascular death) in a large, complete real-world population with COPD without previous CVD. Methods: We conducted a retrospective population cohort study using health administrative, medication, laboratory, electronic medical record and other data from Ontario, Canada. People without a history of CVD with and without physician-diagnosed COPD were followed between 2008 and 2016, and cardiac risk factors and comorbidities compared. Sequential cause-specific hazard models adjusting for these factors determined the risk of MACE in people with COPD. Results: Among ∼5.8 million individuals in Ontario aged ≥40 years without CVD, 152 125 had COPD. After adjustment for cardiovascular risk factors, comorbidities and other variables, the rate of MACE was 25% higher in persons with COPD compared with those without COPD (hazard ratio 1.25, 95% CI 1.23-1.27). Conclusions: In a large real-world population without CVD, people with physician-diagnosed COPD were 25% more likely to have a major CVD event, after adjustment for CVD risk and other factors. This rate is comparable to the rate in people with diabetes and calls for more aggressive CVD primary prevention in the COPD population. Competing Interests: Conflict of interest: D.D. Sin reports having received small honoraria from GSK, AstraZeneca and Boehringer Ingelheim, and is Deputy Chief Editor of the European Respiratory Journal. A.S. Gershon is on the Editorial Board of the European Respiratory Journal. All other authors have nothing to disclose. (Copyright ©The authors 2023. For reproduction rights and permissions contact permissions@ersnet.org.)
Databáze:	MEDLINE
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