Effect of severity of exacerbations of COPD and hospitalised pneumonia on risk of myocardial infarction

Abstract

Background: Previous work has suggested that acute exacerbations of COPD are temporally associated with increased risk of myocardial infarction (MI). We aimed to estimate the risk of MI associated with GP treated (moderate) AECOPD, hospitalised (severe) AECOPD, and hospitalised pneumonia. Methods: We identified COPD patients with both an AECOPD and a first MI between 01/01/04-31/03/15 from the UK Clinical Practice Research Datalink (CPRD) using previously validated algorithms. We performed a self-controlled case series to make within person comparisons of the rate of MI in the 91 days following onset of AECOPD or pneumonia compared to their own stable periods. Results: We included 3459 COPD patients in the analysis. Risk of MI was increased in the 91 days following AECOPD or pneumonia. Risk of MI associated with AECOPD was higher for hospitalised compared to moderate events (moderate AECOPD IRR 1.44, 95% CI 1.33-1.57; hospital treated AECOPD IRR 2.58, 95% CI 2.26-2.95; p Figure 1. Risk of MI associated with AECOPD and hospitalised pneumonia Conclusion: The risk of MI in COPD patients is significantly higher for severe AECOPD and hospitalised pneumonia than moderate AECOPD. Funded by GSK and the MRC