Ischemic ECG abnormalities are associated with an increased risk for death among subjects with COPD, also among those without known heart disease

Nilsson, Ulf; Blomberg, Anders; Johansson, Bengt; Bäckman, Helena; Eriksson, Berne; Lindberg, Anne

doi:10.2147/copd.s136404

Cited by 11 publications

(24 citation statements)

References 41 publications

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“…The risk of death also persisted after adjustment for COPD severity. 70 Underuse of beta-blockers, statins, and antiplatelet drugs is frequent in patients with IHD and COPD, and possibly contributes to a worse prognosis. 71,72 Nevertheless, even in patients with IHD adequately treated, the presence of COPD confirmed by spirometry is associated with an increase in cardiovascular events and mortality during the follow-up.…”

Section: Primary Studiesmentioning

confidence: 99%

<p>Insights into Chronic Obstructive Pulmonary Disease as Critical Risk Factor for Cardiovascular Disease</p>

Almagro¹,

Boixeda²,

Díez-Manglano³

et al. 2020

COPD

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In patients with chronic obstructive pulmonary disease (COPD), cardiovascular comorbidities are highly prevalent and associated with considerable morbidity and mortality. This coincidence is increasingly seen in the context of a "cardiopulmonary continuum" rather than being simply attributed to shared risk factors, in particular, cigarette smoking. Both disease entities are centrally linked to systemic inflammation as well as aging, arterial stiffness, and several common biomarkers that led to the development of pulmonary hypertension, left ventricular diastolic dysfunction, atherosclerosis, and reduced physical activity and exercise capacity. For these reasons, COPD should be considered an independent factor of high cardiovascular risk, and efforts should be directed to early identification of cardiovascular disease (CVD) in COPD patients. Assessment of the overall cardiovascular risk is especially important in patients with severe exacerbation episodes, and the same therapeutic target levels for glycosylated hemoglobin, low-density lipoprotein cholesterol (LDL-C), or blood pressure than those recommended by clinical practice guidelines for patients at high cardiovascular risk, should be achieved. In this review, we will discuss the most recent evidence of the role of COPD as a critical cardiovascular risk factor and try to find new insights and potential prevention strategies for this disease.

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Section: Primary Studiesmentioning

confidence: 99%

<p>Insights into Chronic Obstructive Pulmonary Disease as Critical Risk Factor for Cardiovascular Disease</p>

Almagro¹,

Boixeda²,

Díez-Manglano³

et al. 2020

COPD

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“…The study design of the Obstructive Lung Disease in Northern Sweden (OLIN) COPD study has previously been described in detail [7,17]. In summary, the COPD population in this study (n = 993) was identified after reexamination including spirometry of four previously recruited population-based cohorts in 2002-04 (n = 4200), together with n = 993 non-obstructive referents matched by age and sex.…”

Section: Study Design and Study Populationmentioning

confidence: 99%

“…Still, patients with COPD may be less likely to receive cardiovascular preventative therapies [5], albeit most guidelines for diagnosis and treatment of COPD [6] include recommendations regarding evaluation of cardiovascular risk factors and the presence of cardiovascular disease. However, no biomarker has been shown to identify subclinical cardiovascular disease in a representative population-based cohort of individuals with COPD, even though ischemic abnormalities on electrocardiogram (ECG) are suggested to be associated with worse prognosis [7].…”

Section: Introductionmentioning

confidence: 99%

Cardiac biomarkers of prognostic importance in chronic obstructive pulmonary disease

et al. 2020

Self Cite

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Ischemic heart disease is common in COPD and associated with worse prognosis. This study aimed to investigate the presence and prognostic impact of biomarkers of myocardial injury and ischemia among individuals with COPD and normal lung function, respectively. Methods: In 2002-04, all individuals with airway obstruction (FEV 1 /VC < 0.70, n = 993) were identified from population-based cohorts, together with age and sex-matched non-obstructive referents. At re-examination in 2005, spirometry, Minnesota-coded ECG and analyses of high-sensitivity cardiac troponin I (hs-cTnI) were performed in individuals with COPD (n = 601) and those with normal lung function (n = 755). Deaths were recorded until December 31st, 2010. Results: Hs-cTnI concentrations were above the risk stratification threshold of ≥5 ng/L in 31.1 and 24.9% of those with COPD and normal lung function, respectively. Ischemic ECG abnormalities were present in 14.8 and 13.4%, while 7.7 and 6.6% had both elevated hs-cTnI concentrations and ischemic ECG abnormalities. The 5-year cumulative mortality was higher in those with COPD than those with normal lung function (13.6% vs. 7.7%, p < 0.001). Among individuals with COPD, elevated hs-cTnI both independently and in combination with ischemic ECG abnormalities were associated with an increased risk for death (adjusted hazard ratio [HR]; 95% confidence interval [CI] 2.72; 1.46-5.07 and 4.54; 2.25-9.13, respectively). Similar associations were observed also among individuals with COPD without reported ischemic heart disease. Conclusions: In this study, elevated hs-cTnI concentrations in combination with myocardial ischemia on the electrocardiogram were associated with a more than four-fold increased risk for death in a population-based COPDcohort, independent of disease severity.

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“…Severity of COPD: by making the mild stage of COPD reference, other stages are 3.2 more likely to develop abnormal ECG/AOR 3. 27,31 This is mainly due to the exacerbation of the disease resulting in systemic comorbidities including CVDs as evidenced by ECG.…”

Section: Discussionmentioning

confidence: 99%

“…The identified factors for ECG changes were amount of systemic C-reactive proteins (CRP) as markers of inflammation, hypoxia, duration and severity of COPD which was exacerbated by mutual risk factors smoking and aging. [26][27][28][29][30][31][32][33] Thus, the current study aimed to explore and detect changes of ECG pattern by using the 12 lead ECG which is not routinely performed especially in developing countries including Ethiopia and the study area due to economic constraints and determine the associated risk factors among COPD patients.…”

Section: Introductionmentioning

confidence: 99%

Changes on Electrocardiographic Patterns and Associated Factors among Chronic Obstructive Pulmonary Disease Patients

Demissie¹,

Tadessa²,

Tegene³

et al. 2019

Heart Res Open J

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Background Chronic obstructive pulmonary disease (COPD) is a preventable and treatable disease characterized by airflow limitation that is not fully reversible. The lungs and the heart are so closely interrelated organs that diseases of the one results in impaired functioning of the other. COPD induced cardiovascular diseases (CVDs) are diagnosed by electrocardiogram (ECG) and other instruments. ECG is one of the basic diagnostic tools that uses in early screening of COPD associated systemic effect of CVDs. However, concomitant CVDs among COPD patients are not usually assessed by ECG in routine medical practice at the setup. Objective The present study aimed to explore and detect changes of ECG pattern, and determine the associated risk factors among COPD patients. Materials and Methods The study was conducted among COPD patients visiting chest clinic of Jimma Medical Center (JMC), Southwest Ethiopia; from May 18 to August 18, 2017 G.C. A hospital based cross-sectional study was conducted among 80 COPD patients; and investigations for 12 lead resting supine ECG as well as measurements of other variables were performed. The results of ECG patterns and other variables were entered into Epidata (3.1) and exported to statistical package for the social sciences (SPSS) 20 for further analysis. Results Eighty COPD patients were enrolled in the study and the prevalence of abnormal ECG was 83.75% where arrhythmia accounted for 50%, atrial enlargement 48.8%, myocardial infarction (MI) 41.3%, axis deviation 35%, other ECG abnormalities (poor R-wave progression and low QRS amplitude) 35% and ventricular hypertrophy 15%. The identified associated factors with the abnormal ECG were less monthly income, smoking, hypoxia, male gender and severity of COPD with their specific adjusted odds ratio (AOR) and 95% CI of 2.1(1.6-7.9), 2.2(1.5-8.6), 2.9(1.2-6.9), 3.1(1.5-23) and 3.2(2.0-8.4) respectively. Conclusion Routine ECG investigation should be performed at the setup to initiate early management of CVDs comorbidity for better prognosis among COPD as abnormal ECG is inevitable among them.

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Ischemic ECG abnormalities are associated with an increased risk for death among subjects with COPD, also among those without known heart disease

Cited by 11 publications

References 41 publications

<p>Insights into Chronic Obstructive Pulmonary Disease as Critical Risk Factor for Cardiovascular Disease</p>

<p>Insights into Chronic Obstructive Pulmonary Disease as Critical Risk Factor for Cardiovascular Disease</p>

Cardiac biomarkers of prognostic importance in chronic obstructive pulmonary disease

Changes on Electrocardiographic Patterns and Associated Factors among Chronic Obstructive Pulmonary Disease Patients

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