Are adults with COPD in Australian primary care at a greater risk of cardiovascular events than adults without COPD?.

Abstract

Greater understanding of long-term cardiovascular (CVD) risks in people with chronic obstructive pulmonary disease (COPD) is needed for prevention and proactive management strategies. The risk of new-onset stroke, heart failure (HF) and myocardial infarction (MI) in adults (>40 years) with and without COPD were compared using an age and gender-matched cohort study from the Optimum Patient Care Research Database Australia (OPCRDA). Patients were followed up from 1 Jan 2014 ('index date') until date of first CVD event, clinical inactivity (no healthcare contacts >1yr) or 5 years, whichever was first. Differences in stroke, HF and MI over time were compared using Cox and flexible parametric models. 3,863 patients with COPD (mean age: 71.7yrs; 50.7% male) were matched (1:1) to people without COPD. HF was the most common CVD event (4.5%), followed by stroke (3.2%) and MI (2.5%). All CVD events were 2-3 times higher in people with COPD (MI: hazard ratio [HR] 2.75 [95% CI 1.98,3.82]; HF: 2.21 [1.74,2.40]; stroke: 1.70 [1.31-2.21]). The probability of a new CVD event was consistently higher for COPD patients over time (see Figure). New-onset CVD events occurred more frequently in adults with COPD compared to those without COPD in this Australian primary care cohort. Further work is needed to explore the influence of exacerbations and inflammatory markers on CVD comorbidities.