Objectives: Pulmonary Embolism has been frequently reported in Acute Exacerbations of Chronic Obstructive Pulmonary Disease (AE-COPD). The study aimed to determine whether COPD patients who receive anticoagulant (AC) therapy have a reduced risk of hospitalization due to AE-COPD and death. Methods: This nationwide population-based study was based on data from the Danish Register of COPD (DrCOPD), which contains complete data on COPD outpatients between 1st January 2010 and 31st December 2018. National registers were used to obtain information regarding comorbidities and vital status. Propensity-score matching and Cox proportional hazards models were used to assess AE-COPD and death after one year. Results: The study cohort consisted of 58,067 patients with COPD. Of these, 5194 patients were on AC therapy. The population was matched 1:1 based on clinical confounders and AC therapy, resulting in two groups of 5180 patients. We found no association between AC therapy and AE-COPD or all-cause mortality in the propensity-score matched population (HR 1.03, 95% CI 0.96-1.10, p = 0.37). These findings were confirmed in a competing risk analysis. In the sensitivity analysis, we performed an adjusted analysis of the complete cohort and found a slightly increased risk of AE-COPD or death in patients treated with AC therapy. This study found a low incidence of pulmonary embolisms and deep venous thrombosis in both groups. Conclusions: AC therapy was not associated with the risk of hospitalization due to AE-COPD or all-cause mortality.

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BackgroundChronic low-grade inflammation as in asthma may lead to a higher risk of cardiovascular events. We evaluated if patients with chronic obstructive pulmonary disease (COPD) and asthma have a higher risk of acute cardiovascular events than patients with COPD without asthma.MethodsNationwide multi-center retrospective cohort study of Danish outpatients with a specialist diagnosis of COPD with or without asthma. Patients with both COPD and asthma were propensity score matched 1: 2 to patients with COPD without asthma. The primary endpoint was severe major adverse cardiac events (MACE), defined as mortal cardiovascular events and events requiring revascularization or hospitalization.ResultsA total of 52 386 Danish patients with COPD were included, 34.7% had pre-existing cardiovascular disease, and 20.1% had asthma in addition to their COPD. Patients with pre-existing cardiovascular disease were then propensity score matched: 3690 patients with COPD and asthma versus 7236 patients with COPD without asthma. Similarly, for patients without pre-existing cardiovascular disease (6775 matched with 13 205).The risk of MACE was higher among patients with asthma and COPD versus COPD without asthma: Hazard ratio (HR): 1.25 (CI 1.13–1.39, p<0.0001) for patients with pre-existing cardiovascular disease and HR 1.22 (CI 1.06–1.41, p=0.005) for patients without pre-existing cardiovascular disease.ConclusionAmong patients with COPD, asthma as a comorbid condition is associated with substantially increased risk of cardiovascular events. The signal was an increased risk of 20–25%. Based on our study and other smaller studies, asthma can be considered a risk factor for cardiovascular events among COPD patients.