Major cardiovascular events in patients with severe COPD with and without asthma: a nationwide cohort study

Barbara Bonnesen, Pradeesh Sivapalan, Anna Kjær Kristensen, Mats Christian Højbjerg Lassen, Kristoffer Grundtvig Skaarup, Ema Rastoder, Rikke Sørensen, Josefin Eklöf, Tor Biering-Sørensen, Jens-Ulrik Stæhr Jensen*

*Corresponding author for this work

Abstract

Background: Chronic low-grade inflammation as in asthma may lead to a higher risk of cardiovascular events. We evaluated whether patients with COPD and asthma have a higher risk of acute cardiovascular events than patients with COPD without asthma.

Methods: Nationwide multicentre retrospective cohort study of Danish outpatients with a specialist diagnosis of COPD with or without asthma. Patients with both COPD and asthma were propensity-score matched 1:2 to patients with COPD without asthma. The primary end-point was severe major adverse cardiac events (MACE), defined as mortal cardiovascular events and events requiring revascularisation or hospitalisation.

Results: A total of 52 386 Danish patients with COPD were included; 34.7% had pre-existing cardiovascular disease, and 20.1% had asthma in addition to their COPD. Patients with pre-existing cardiovascular disease were then propensity-score matched: 3690 patients with COPD and asthma versus 7236 patients with COPD without asthma, and similarly, for patients without pre-existing cardiovascular disease (6775 matched with 13 205). The risk of MACE was higher among patients with asthma and COPD versus COPD without asthma: hazard ratio (HR) 1.25 (95% CI 1.13-1.39, p<0.0001) for patients with pre-existing cardiovascular disease and HR 1.22 (95% CI 1.06-1.41, p=0.005) for patients without pre-existing cardiovascular disease.

Conclusion: Among patients with COPD, asthma as a comorbid condition is associated with substantially increased risk of cardiovascular events. The signal was an increased risk of 20-25%. Based on our study and other smaller studies, asthma can be considered a risk factor for cardiovascular events among COPD patients.

Original languageEnglish
Article number00200-2022
JournalERJ Open Research
Volume8
Issue number3
ISSN2312-0541
DOIs
Publication statusPublished - Jul 2022

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