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Enkyu Noh,1,* Hyungmin Jeong,1,* In-So Cho,2 Min-Seok Chang,2 Iseul Yu,2 Sunmin Park,2 Ji-Ho Lee,2 Seok Jeong Lee,2 Won-Yeon Lee,2 Suk Joong Yong,2 Sang-Ha Kim2 1Yonsei University Wonju College of Medicine, Wonju, 26426, Korea; 2Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, 26426, Korea*These authors contributed equally to this workCorrespondence: Sang-Ha Kim, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju 26426, Korea, 20 Ilsanro, Wonju, 26426, Korea, Tel +82-33-741-0926, Fax +82-33-746-4667, Email sanghakim@yonsei.ac.krPurpose: Chronic obstructive pulmonary disease (COPD) and metabolic syndrome (MetS) are among the most prevalent conditions that might predispose individuals to life-threatening events. We aimed to examine their associations with cardiovascular (CV) events and mortality using a large-scale population dataset from the National Health Information Database in Korea.Patients and Methods: This population-based cohort study enrolled adults aged ≥ 40 years who had undergone more than two health examinations between 2009 and 2011. They were divided into four groups based on the presence of COPD and MetS. Analysis of the outcomes and CV events or deaths was performed from 2014 to 2019. We compared CV event incidence and mortality rates using a multivariate Cox proportional hazards model and Kaplan–Meier curves.Results: Totally, 5,101,810 individuals were included, among whom 3,738,458 (73.3%) had neither COPD nor MetS, 1,193,014 (23.4%) had only MetS, 125,976 (2.5%) had only COPD, and 44,362 (0.9%) had both. The risk of CV events was significantly higher in individuals with both COPD and MetS than in those with either COPD or MetS alone (HRs: 2.4 vs 1.6 and 1.8, respectively; all P < 0.001). Similarly, among those with both COPD and MetS, all-cause and CV mortality risks were also elevated (HRs, 2.9 and 3.0, respectively) compared to the risks in those with either COPD (HRs, 2.6 and 2.1, respectively) or MetS (HRs, 1.7 and 2.1, respectively; all P < 0.001).Conclusion: The comorbidity of MetS in patients with COPD increases the incidence of CV events and all-cause and cardiovascular mortality rates.Keywords: cardiovascular event, chronic obstructive pulmonary disease, metabolic syndrome |
