Hean Ooi1,2,3,4, Li-Hsiou Chen5, Yung-Lun Ni5, Huan-Ting Shen5, Yen-Hsien Lee5, Yi-Chun Chu2, Ke-Chih Fang2, I-Hung Chen2, Shu-Lan Hsu2, Hsing-Chun Chen2, Chien-Hsiu Huang2, Kuo-Sheng Fan2, Chun-Liang Lai2, Liang-Wen Hang6,7,8. 1. Department of Preventive Medicine, Taichung Tzu Chi Hospital, Taiwan. No. 66, Sec. 1, Fongsing Road, Tanzi District, Taichung City 427, Taiwan. 2. Division of Pulmonology and Critical Care, Department of Internal Medicine, Dalin Tzu Chi Hospital, Taiwan. No.2, Minsheng Rd, Dalin Township Chiayi County 622, Taiwan. 3. Department of Medical Imaging and Radiological Sciences, Central Taiwan University of Science and Technology, No. 11, Buzih Lane 40601, Taiwan. 4. Department of Medical Research, China Medical University Hospital, China Medical University, Taiwan. No. 2, Yu der Road, Taichung City 40447, Taiwan. 5. Division Chest, Department of Internal Medicine, Taichung Tzu Chi Hospital, Taiwan. No. 66, Sec. 1, Fongsing Road, Tanzi District, Taichung City 427, Taiwan. 6. Department of Internal Medicine, Sleep Medicine Center, China Medical University Hospital, Taichung, Taiwan. 7. Department of Respiratory Therapy, College of Health Care, China Medical University, Taichung, Taiwan. 8. Department of Healthcare Administration, Asia University, Taichung, Taiwan.
Abstract
INTRODUCTION: Patients with chronic obstructive pulmonary disease (COPD) frequently experience concurrent comorbidities; therefore, risk assessment for major adverse cardiovascular events (MACEs) is very important. OBJECTIVES: We explored the association between COPD and risk of MACEs with three common clinical events: acute myocardial infarction (AMI), ischemic stroke (IS), and cardiovascular death (CVD). METHODS: We evaluated the predictive value of the CHA2DS2-VASc score (congestive heart failure [C], hypertension [H], age [A], diabetes [D], stroke [S], and vascular disease [VASc]) for MACEs in COPD patients. In this observational study, we retrospectively reviewed the records of 29 258 patients with COPD between 2005 and 2009 in relation to MACE risk using the CHA2DS2-VASc score. We calculated the hazard ratios (HR) and 95% confidence intervals (CI) using a significance level of .05. RESULTS: Patients with COPD had significantly (P < .001) increased risk of MACEs, and a high prevalence of CHA2DS2-VASc scores ≥ 6, predicting MACEs (16.1%), AMI (3.3%), IS (8.7%), and CVD (4.0%). A good discrimination was found for MACEs, IS events, and CVD events (AUC = 0.740, 0.739, and 0.778, respectively) but poorer discrimination for AMI events (AUC = 0.697). CONCLUSION: Early lifestyle modifications and antithrombotic therapy may be essential for COPD patients at a high risk of MACEs, that is, those with CHA2DS2-VASc scores ≥ 6.
INTRODUCTION:Patients with chronic obstructive pulmonary disease (COPD) frequently experience concurrent comorbidities; therefore, risk assessment for major adverse cardiovascular events (MACEs) is very important. OBJECTIVES: We explored the association between COPD and risk of MACEs with three common clinical events: acute myocardial infarction (AMI), ischemic stroke (IS), and cardiovascular death (CVD). METHODS: We evaluated the predictive value of the CHA2DS2-VASc score (congestive heart failure [C], hypertension [H], age [A], diabetes [D], stroke [S], and vascular disease [VASc]) for MACEs in COPDpatients. In this observational study, we retrospectively reviewed the records of 29 258 patients with COPD between 2005 and 2009 in relation to MACE risk using the CHA2DS2-VASc score. We calculated the hazard ratios (HR) and 95% confidence intervals (CI) using a significance level of .05. RESULTS:Patients with COPD had significantly (P < .001) increased risk of MACEs, and a high prevalence of CHA2DS2-VASc scores ≥ 6, predicting MACEs (16.1%), AMI (3.3%), IS (8.7%), and CVD (4.0%). A good discrimination was found for MACEs, IS events, and CVD events (AUC = 0.740, 0.739, and 0.778, respectively) but poorer discrimination for AMI events (AUC = 0.697). CONCLUSION: Early lifestyle modifications and antithrombotic therapy may be essential for COPDpatients at a high risk of MACEs, that is, those with CHA2DS2-VASc scores ≥ 6.
Authors: Serge C Harb; Tom Kai Ming Wang; David Nemer; Yuping Wu; Leslie Cho; Venu Menon; Osama Wazni; Paul C Cremer; Wael Jaber Journal: Open Heart Date: 2021-11
Authors: Julia Shanks; Zhiqiu Xia; Steven J Lisco; George J Rozanski; Harold D Schultz; Irving H Zucker; Han-Jun Wang Journal: Physiol Rep Date: 2018-06