Hospitalization for acute COPD exacerbation linked to mortality of subsequent CV events

Preceding hospitalization for acute COPD exacerbation was associated with increased risk for 90-day and overall mortality of cardiovascular events, according to a study published in CHEST.

“COPD and cardiovascular comorbidities reciprocally exert a negative impact on disease progression, quality of life and disease outcomes,” Mai Wang, MBBS, of the Center for Quantitative Sciences and the department of biostatistics at Vanderbilt University Medical Center, and colleagues wrote. “The current study further shows an increased mortality risk of cardiovascular events in patients with COPD following hospitalization for [acute exacerbation].”

Researchers analyzed a health insurance research database in Taiwan to identify patients with COPD who experienced first-time acute myocardial infarction (n = 26,442), ischemic stroke (n = 54,959) and intracranial hemorrhage (n = 14,893) over 13 years to investigate whether preceding acute COPD exacerbation was associated with mortality of CV events.

Overall, 4,356 patients with acute MI, 6,655 patients with ischemic stroke and 1,727 patients with intracranial hemorrhage were hospitalized for acute COPD exacerbation within the prior year. Patients with COPD without hospitalization for acute exacerbation served as the control group.

Researchers observed an independent association of acute exacerbation hospitalization with 90-day mortality for acute MI (OR = 1.33; 95% CI, 1.24-1.43), ischemic stroke (OR = 1.46; 95% CI, 1.36-1.56) and intracranial hemorrhage (OR = 1.19; 95% CI, 1.06-1.32). Hospitalization for acute exacerbation was also associated with overall mortality of acute MI (HR = 1.23; 95% CI, 1.19-1.27), ischemic stroke (HR = 1.29; 95% CI, 1.26-1.33) and intracranial hemorrhage (HR = 1.19; 95% CI, 1.13-1.26).

The researchers also reported a significant trend toward higher risk for 90-day and overall mortality of acute MI, ischemic stroke and intracranial hemorrhage among patients with higher frequency of hospitalization for acute exacerbation compared with the controls (P < .001).

According to Wang and colleagues, optimizing integrated care is necessary to alleviate CV event mortality in this group of patients due to the great mortality risk and incidence.

“Because CVDs account for a substantial proportion of deaths in COPD, treating physicians should have heightened vigilance for the increased mortality risk following cardiovascular events among patients with severe [acute exacerbation],” the researchers wrote.