Abstract WP281: Investigating the Incidence of Stroke in Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis

Abstract

Background: Chronic obstructive pulmonary disorder (COPD) is a progressive respiratory disorder ranking third in global mortality. It often correlates with new cardiovascular incidents including stroke, affecting both management and prognostic considerations. The precise relationship between the incidence of stroke and COPD remains unclear. We performed a meta-analysis to determine the incidence of stroke in COPD patients. Methods: The PubMed and EMBASE databases were searched using predefined search terms encompassing COPD, emphysema, chronic bronchitis, and stroke related terms. The search timeline included the earliest available date until April 2023, including studies that investigated stroke occurrence in COPD patients. The analysis was conducted using CMA v.3 and R (Version: 4.3.1). The number of patients with COPD and stroke in each study were extracted and analyzed. A random-effects model was employed to calculate the incidence, pooled odds ratio (OR), and corresponding 95% confidence intervals (CIs). Heterogeneity was assessed using the I^2 statistic. The prediction interval was calculated to explain the distribution of the true effects. Results: A total of 33 studies matched our inclusion criteria, with a total of 865521 COPD patients. The weighted mean age of the population was 60.46 years, and 98739 of them had an incident of stroke in their lifetime. From the pooled analysis of all 33 included studies, using the random effects model, the incidence of stroke was 7.6% (Proportion, 0.076; 95% CI, 0.060 - 0.095, I2=99%). The prediction interval was calculated to be 0.02-0.27. Our analysis also showed a pooled odds ratio of 1.355 (95% CI:1.281-1.432, I2=99.96%) using the random effects model. Conclusion: We report a 7.6% incidence of stroke in COPD patients, and an increase in the odds of stroke in individuals with COPD. The cardiovascular health of such patients should be adequately monitored to mitigate the risk of stroke.