Age, hypertension, COPD are risk factors for CV events after bronchiectasis exacerbation

In a new study published in Chest, cardiovascular events occurred in 30% of patients with bronchiectasis after an acute exacerbation.

Several demographic factors and comorbidities were identified as risk factors for developing CV events following a bronchiectasis exacerbation, including age, hypertension, COPD and severity of exacerbation.

“The identification of specific risk factors for CV events and potentially the use of biomarkers such as pro-adrenomedullin may allow us to select patients with bronchiectasis who are most likely to benefit from the treatable traits strategy, preventive cardiovascular programs and for designing clinical trials to modify that risk and mortality,” Raúl Méndez, MD, PhD, from the department of pneumology at La Fe University and Polytechnic Hospital and the Respiratory Infections Research Group in Valencia, Spain, and colleagues wrote. “Cardiovascular risk should be acknowledged as a modifiable treatable trait that merits attention to improve morbidity and survival.”

The researchers conducted a post hoc retrospective analysis of a prospective observational study that included 250 patients with bronchiectasis (mean age, 72 years; 58% women) at two tertiary care hospitals in Spain. Researchers collected data on the first bronchiectasis exacerbation, along with data on demographics, comorbidities and exacerbation severity.

The primary outcomes were development of CV events and mortality.

During a median follow-up of 35 months, 29.6% of patients experienced a CV event, 11.6% had more than one CV event and 37.2% died. The most common CV events reported were arrhythmias (41.9%), acute heart failure (37.8%), acute coronary syndrome (12.2%) and cerebrovascular accident (8.1%).

Researchers observed significantly increased risk for CV events with age (HR = 1.05; 95% CI, 1.02-1.08), arterial hypertension (HR = 2.12; 95% CI, 1.21-3.72), COPD (HR = 1.86; 95% CI, 1.14-3.04) and potentially severe exacerbations (HR = 1.85; 95% CI, 0.98-3.52) in a semi-competing risk analysis.

COPD (HR = 3.19; 95% CI, 1.61-6.3), age (HR = 1.08; 95% CI, 1.04-1.13) and severe exacerbations (HR = 2; 95% CI, 0.8-5.02) were identified as risk factors associated with higher mortality among patients with bronchiectasis.