Mortality of Cardiovascular Events in Patients With COPD and Preceding Hospitalization for Acute Exacerbation

Wang, Mai; Lin, Emily; Huang, Li; Li, Chung‐Yi; Shyr, Yu; Lai, Chao Han

doi:10.1016/j.chest.2020.02.046

Cited by 36 publications

(26 citation statements)

References 42 publications

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“…Many studies have reported an increased risk of cardiovascular events in patients with acute exacerbation of COPD, especially within the first 30 days after acute exacerbation (22)(23)(24). Therefore, in addition to paying greater attention to the treatment of patients with COPD and COVID-19 during hospitalization, it is also important to follow up these patients for some time after rehabilitation, to further reduce mortality (25).…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics of COVID-19 infection in chronic obstructive pulmonary disease: a multicenter, retrospective, observational study

Wu¹,

Zhou²,

Wang³

et al. 2020

J Thorac Dis

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Background: Coronavirus disease 2019 (COVID-19) has been a global pandemic disease, with more than 4 million cases and nearly 300,000 deaths. Little is known about COVID-19 in patients with chronic obstructive pulmonary disease (COPD). We aimed to evaluate the influence of preexisting COPD on the progress and outcomes of COVID-19. Methods: This was a multicenter, retrospective, observational study. We enrolled 1,048 patients aged 40 years and above, including 50 patients with COPD and 998 patients without COPD, and with COVID-19 confirmed via high-throughput sequencing or real-time reverse transcription-polymerase chain reaction, between December 11, 2019 and February 20, 2020. We collected data of demographics, pathologic test results, radiologic imaging, and treatments. The primary outcomes were composite endpoints determined by admission to an intensive care unit, the use of mechanical ventilation, or death. Results: Compared with patients who had COVID-19 but not COPD, those with COPD had higher rates 1812 Wu et al.

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Section: Discussionmentioning

confidence: 99%

Clinical characteristics of COVID-19 infection in chronic obstructive pulmonary disease: a multicenter, retrospective, observational study

Wu¹,

Zhou²,

Wang³

et al. 2020

J Thorac Dis

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“…Hospitalised AECOPD are associated with substantial mortality and an enriched risk of subsequent major adverse cardiovascular events [2,3]. Hospitalisation therefore represents a favourable opportunity to diagnose and intervene in cardiac disease by implementing wellestablished treatment pathways with recognised treatment benefits [11][12][13].…”

Section: Discussionmentioning

confidence: 99%

“…Acute Exacerbations of Chronic Obstructive Pulmonary Disease (AECOPD) are complex, heterogenous events accompanied by a surge in cardiovascular risk and death [1][2][3]. Cardiac involvement, manifest as biomarkers of myocardial dysfunction, can be detected in up to 60% of acute exacerbations [2].…”

Section: Introductionmentioning

confidence: 99%

“…Cardiac involvement, manifesting as biomarkers of myocardial dysfunction, can be detected in up to 60% of acute exacerbations [ 2 ]. When present, this heralds reduced survival [ 2 , 3 ]. Despite the frequency and importance of this signal, relationships between COPD and cardiovascular disease are imperfectly understood, particularly during AECOPD [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

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Treatable cardiac disease in hospitalised COPD exacerbations

et al. 2021

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IntroductionAcute exacerbations of COPD (AECOPD) are accompanied by escalations in cardiac risk superimposed upon elevated baseline risk. Appropriate treatment for coronary artery disease (CAD) and heart failure with reduced ejection fraction (HFrEF) could improve outcomes. However, securing these diagnoses during AECOPD is difficult, so their true prevalence remains unknown, as does the magnitude of this treatment opportunity. We aimed to determine the prevalence of severe CAD and severe HFrEF during hospitalised AECOPD using dynamic computed tomography (CT).MethodsA cross-sectional study of 148 patients with hospitalised AECOPD was conducted. Dynamic CT was used to identify severe CAD (Agatston score ≥400) and HFrEF (left ventricular ejection fraction ≤40% and/or right ventricular ejection fraction ≤35%).ResultsSevere CAD was detected in 51 of 148 patients (35%), left ventricular systolic dysfunction was identified in 12 cases (8%) and right ventricular systolic dysfunction was present in 18 (12%). Clinical history and examination did not identify severe CAD in approximately one-third of cases and missed HFrEF in two-thirds of cases. Elevated troponin and brain natriuretic peptide did not differentiate subjects with severe CAD from nonsevere CAD, nor distinguish HFrEF from normal ejection fraction. Undertreatment was common. Of those with severe CAD, only 39% were prescribed an antiplatelet agent, and 53% received a statin. Of individuals with HFrEF, 50% or less received angiotensin blockers, beta blockers or antimineralocorticoids.ConclusionDynamic CT detects clinically covert CAD and HFrEF during AECOPD, identifying opportunities to improve outcomes via well-established cardiac treatments.

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“…3 In a recent study, patients with COPD are at a higher risk of cardiovascular mortality. 4 COPD is characterized by dyspnea, poor health-related quality of life (HRQL), and insufficient cardiorespiratory endurance during exercise. 5 Even in patients with mild COPD, exercise performance is compromised, and exercise intolerance is also common.…”

Section: Introductionmentioning

confidence: 99%

Poor Work Efficiency is Associated with Poor Exercise Capacity and Health-Related Quality of Life in Patients with Chronic Obstructive Pulmonary Disease

Yang¹,

Yang²,

Wu³

et al. 2021

COPD

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Introduction: Chronic obstructive pulmonary disease (COPD) is a progressive disease with deteriorating cardiopulmonary function that decreases the health-related quality of life (HRQL) and exercise capacity. Patients with COPD often have cardiovascular and muscular problems that hinder oxygen uptake by peripheral tissues, resulting in poor oxygen consumption efficiency. It is important to develop new physiological parameters to evaluate oxygen consumption efficiency during activities and to evaluate its association with exercise capacity and HRQL. Work efficiency (WE) measures oxygen consumption efficiency during exercise. We hypothesize that patients with poor WE should have exercise intolerance and poor HRQL. Therefore, we aimed to evaluate the association between WE and exercise capacity, HRQL and other cardiopulmonary parameters. Patients and Methods: Seventy-eight patients with COPD were evaluated with spirometry, cardiopulmonary exercise testing, and assessment of dyspnea score and HRQL (using the St. George's Respiratory Questionnaire [SGRQ]). Cardiopulmonary exercise testing was performed using a cycle ergometer with an incremental protocol and exhaled breath analysis to assess oxygen consumption. WE was defined as the relationship between oxygen consumption and workload. Results: There were 31 patients with normal WE (group I) and 47 patients (group II) with poor WE. Patients with poor WE had lower exercise capacity (maximal oxygen consumption, group I vs II as 1050±53 vs 845 ±34 mL/min, p=0.0011), poorer HRQL (SGRQ score 41.1±3.0 vs 55±2.2, p=0.0002), higher exertional dyspnea score (5.1±0.2 vs 6.1±0.2, p= 0.0034) and early anaerobic metabolism during exercise (anaerobic threshold, 672±27 vs 583 ±18 mL/min, p=0.0052). Conclusion: WE is associated with exercise capacity and HRQL. Here, patients with poor WE also had exercise intolerance, poorer HRQL, and more exertional dyspnea.

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Mortality of Cardiovascular Events in Patients With COPD and Preceding Hospitalization for Acute Exacerbation

Abstract: The accuracy of the diagnoses in this database regarding COPD, AMI, ischemic stroke, and ICH has been previously validated. 19-22 The three study cohorts were defined as patients with COPD experiencing first-time AMI (n ¼ 26,442), ischemic stroke (n

Cited by 36 publications

References 42 publications

Clinical characteristics of COVID-19 infection in chronic obstructive pulmonary disease: a multicenter, retrospective, observational study

Clinical characteristics of COVID-19 infection in chronic obstructive pulmonary disease: a multicenter, retrospective, observational study

Treatable cardiac disease in hospitalised COPD exacerbations

Poor Work Efficiency is Associated with Poor Exercise Capacity and Health-Related Quality of Life in Patients with Chronic Obstructive Pulmonary Disease

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