Abstract
BackgroundIt has been noted that there is an increase in the incidence of acute cardiovascular events (CVEs) in patients with chronic obstructive pulmonary disease (COPD) during an acute exacerbation (AE), thereby causing increased inpatient mortality. Thus, we have tried to identify predictors of acute CVEs in patients with AECOPD via a nested case–control study.MethodsA total of 496 cases hospitalized for AECOPD were included in this study, and followed-up for up to 6 months after discharge. Acute CVEs in the AE period were defined as a new or worsening acute coronary syndrome (ACS), arrhythmia, or left ventricular disfunction (LVD). Predictors of CVEs were selected from several variables, including baseline characteristics and treatments in the stable period as well as symptoms, laboratory tests, complications and treatments in the AE period.ResultsThirty cases (6.05%) had acute CVEs, namely 2 had ACS, 13 had LVD and 19 experienced some form of arrhythmia. Four deaths were observed in the CVE group, with significantly increased death risk compared with the non-CVE group (P = 0.001, OR = 5.81). Moreover, patients who had CVEs were more prone to have re-exacerbation within 3 months. Multivariate analysis showed that previous LVD history (P = 0.004, OR = 5.06), 20% increase in heart rate (HR) (P = 0.003, OR = 10.19), electrolyte disturbance (P = 0.01, OR = 4.24) and diuretics (P = 0.002, OR = 6.37) were independent predictors of CVEs. In addition, usage of theophylline, fluoroquinolone and inhaled beta agonists in the AE period were not statistically associated with acute CVEs.ConclusionsOur preliminary study indicates that patients hospitalized for AECOPD with previous LVD history or increased HR need close observation and diuretics should be cautiously used with regular electrolyte monitoring. These findings need to be confirmed in a large cohort.
Highlights
IntroductionChronic obstructive pulmonary disease (COPD) is a chronic lung disease characterized by irreversible airflow limitation and progressive decline of lung function, and it is the third leading cause of death in the world [1, 2]
Full list of author information is available at the end of the article
Chronic obstructive pulmonary disease (COPD) is a chronic lung disease characterized by irreversible airflow limitation and progressive decline of lung function, and it is the third leading cause of death in the world [1, 2]
Summary
Chronic obstructive pulmonary disease (COPD) is a chronic lung disease characterized by irreversible airflow limitation and progressive decline of lung function, and it is the third leading cause of death in the world [1, 2]. Several cohort studies reported that cardiovascular disease (CVD) is one of the top three leading causes of death. Previous history of CVD can increase risks of death in elderly COPD patients with pneumonia [6]. Increased risks of acute cardiovascular events (CVEs) namely acute coronary syndrome (ACS) [9], arrhythmias [7] and sudden cardiac death [10] have been reported in the patients with COPD. A large cohort study demonstrated that the prevalence of heart failure among patients with COPD is significantly increased, leading to a higher allcause mortality [11]. It has been noted that there is an increase in the incidence of acute cardiovascular events (CVEs) in patients with chronic obstructive pulmonary disease (COPD) during an acute exacerbation (AE), thereby causing increased inpatient mortality. We have tried to identify predictors of acute CVEs in patients with AECOPD via a nested case–control study
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
