Lies Lahousse1, Maartje N Niemeijer2, Marten E van den Berg3, Peter R Rijnbeek3, Guy F Joos4, Albert Hofman2, Oscar H Franco2, Jaap W Deckers5, Mark Eijgelsheim6, Bruno H Stricker7, Guy G Brusselle8. 1. Department of Respiratory Medicine, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium Department of Epidemiology, Erasmus Medical Center, PO Box 2040, Rotterdam 3000 CA, The Netherlands. 2. Department of Epidemiology, Erasmus Medical Center, PO Box 2040, Rotterdam 3000 CA, The Netherlands. 3. Department of Medical Informatics, Erasmus Medical Center, PO Box 2040, Rotterdam 3000 CA, The Netherlands. 4. Department of Respiratory Medicine, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium. 5. Department of Cardiology, Erasmus Medical Center, PO Box 2040, Rotterdam 3000 CA, The Netherlands. 6. Department of Epidemiology, Erasmus Medical Center, PO Box 2040, Rotterdam 3000 CA, The Netherlands Department of Internal Medicine, Erasmus Medical Center, PO Box 2040, Rotterdam 3000 CA, The Netherlands. 7. Department of Epidemiology, Erasmus Medical Center, PO Box 2040, Rotterdam 3000 CA, The Netherlands Department of Internal Medicine, Erasmus Medical Center, PO Box 2040, Rotterdam 3000 CA, The Netherlands Inspectorate of Healthcare, The Hague, The Netherlands b.stricker@erasmusmc.nl. 8. Department of Respiratory Medicine, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium Department of Epidemiology, Erasmus Medical Center, PO Box 2040, Rotterdam 3000 CA, The Netherlands Department of Respiratory Medicine, Erasmus Medical Center, PO Box 2040, Rotterdam 3000 CA, The Netherlands.
Abstract
AIMS: Both sudden cardiac death (SCD) and chronic obstructive pulmonary disease (COPD) are common conditions in the elderly. Previous studies have identified an association between COPD and cardiovascular disease, and with SCD in specific patient groups. Our aim was to investigate whether there is an association between COPD and SCD in the general population. METHODS AND RESULTS: The Rotterdam study is a population-based cohort study among 14 926 subjects aged 45 years and older with up to 24 years of follow-up. Analyses were performed with a (time dependent) Cox proportional hazard model adjusted for age, sex, and smoking. Of the 13 471 persons included in the analysis; 1615 had a diagnosis of COPD and there were 551 cases of SCD. Chronic obstructive pulmonary disease was associated with an increased risk of SCD (age- and sex-adjusted hazard ratio, HR, 1.34, 95% CI 1.06-1.70). The risk particularly increased in the period 2000 days (5.48 years) after the diagnosis of COPD (age- and sex-adjusted HR 2.12, 95% CI 1.60-2.82) and increased further to a more than three-fold higher risk in COPD subjects with frequent exacerbations during this period (age- and sex-adjusted HR 3.58, 95% CI 2.35-5.44). Analyses restricted to persons without prevalent myocardial infarction or heart failure yielded similar results. CONCLUSION: Chronic obstructive pulmonary disease is associated with an increased risk for SCD. The risk especially increases in persons with frequent exacerbations 5 years after the diagnosis of COPD. This risk indicator could provide new directions for better-targeted actions to prevent SCD. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: Both sudden cardiac death (SCD) and chronic obstructive pulmonary disease (COPD) are common conditions in the elderly. Previous studies have identified an association between COPD and cardiovascular disease, and with SCD in specific patient groups. Our aim was to investigate whether there is an association between COPD and SCD in the general population. METHODS AND RESULTS: The Rotterdam study is a population-based cohort study among 14 926 subjects aged 45 years and older with up to 24 years of follow-up. Analyses were performed with a (time dependent) Cox proportional hazard model adjusted for age, sex, and smoking. Of the 13 471 persons included in the analysis; 1615 had a diagnosis of COPD and there were 551 cases of SCD. Chronic obstructive pulmonary disease was associated with an increased risk of SCD (age- and sex-adjusted hazard ratio, HR, 1.34, 95% CI 1.06-1.70). The risk particularly increased in the period 2000 days (5.48 years) after the diagnosis of COPD (age- and sex-adjusted HR 2.12, 95% CI 1.60-2.82) and increased further to a more than three-fold higher risk in COPD subjects with frequent exacerbations during this period (age- and sex-adjusted HR 3.58, 95% CI 2.35-5.44). Analyses restricted to persons without prevalent myocardial infarction or heart failure yielded similar results. CONCLUSION:Chronic obstructive pulmonary disease is associated with an increased risk for SCD. The risk especially increases in persons with frequent exacerbations 5 years after the diagnosis of COPD. This risk indicator could provide new directions for better-targeted actions to prevent SCD. Published on behalf of the European Society of Cardiology. All rights reserved.
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