Assessment of Cardiovascular Events in Patients With Severe COPD Exacerbations

OBJECTIVES: Chronic obstructive pulmonary disease (COPD) exacerbations have been associated with cardiovascular events (CVE) after the exacerbation. However, limited data are available describing the occurrence of CVE during a COPD exacerbation hospitalization. To address this evidence gap, this study describes the prevalence of CVE within severe COPD exacerbation hospitalizations.

METHODS: This retrospective, observational study utilized the Healthcare Integrated Research Database (HIRD^®). Patients 40 years and older with a severe COPD exacerbation, defined as an inpatient hospitalization with a primary diagnosis of COPD or a primary diagnosis of respiratory failure or pneumonia and a secondary COPD diagnosis, from 10/1/16 to 1/31/24 with no evidence of comorbid respiratory conditions were identified. A minimum of 1-year continuous enrollment prior to the first exacerbation (index) was required. CVE (myocardial infarction, angina or ischemic stroke) were identified during the index COPD exacerbation and patients were stratified based on evidence of cardiovascular disease (CVD) in the year prior.

RESULTS: The study included 48,702 patients, of whom 19,494 (40.0%) had evidence of CVD prior to their first severe COPD exacerbation. The mean (SD) age was 69.3 (11.5) years and 51.9% of patients were female. The majority (72.9%) of patients were White non-Hispanic. Common comorbidities of interest included hypertension (71.7%) and diabetes (30.9%). Among patients with evidence of prior CVD, 16.7% (n=3,254) had a CVE during their severe COPD exacerbation while 9.7% (n=2,840) of those without prior evidence of CVD had a CVE.

CONCLUSIONS: Prior CVD was common in COPD patients having a severe exacerbation. While CVEs were more common in patients with prior CVD (16.7%), almost 10% of patients without a prior history of CVD had a CVE within their COPD exacerbation hospitalization. This suggests that a comprehensive assessment of cardiovascular status regardless of CVD history is important in the care of patients presenting with a severe COPD exacerbation.