Time‐Dependent Risk of Cardiovascular Events Following an Exacerbation in Patients With Chronic Obstructive Pulmonary Disease: Post Hoc Analysis From the IMPACT Trial

Author:

Dransfield Mark T.1ORCID,Criner Gerard J.2,Halpin David M. G.3ORCID,Han MeiLan K.4,Hartley Benjamin5,Kalhan Ravi6ORCID,Lange Peter78ORCID,Lipson David A.910ORCID,Martinez Fernando J.11,Midwinter Dawn12,Singh Dave13,Wise Robert14,Kunisaki Ken M.15ORCID

Affiliation:

1. Lung Health Center University of Alabama at Birmingham Birmingham AL

2. Lewis Katz School of Medicine at Temple University Philadelphia PA

3. University of Exeter Medical School University of Exeter Exeter United Kingdom

4. University of Michigan Ann Arbor MI

5. Veramed Ltd Twickenham United Kingdom

6. Division of Pulmonary and Critical Care Medicine Northwestern University Feinberg School of Medicine Chicago IL

7. University of Copenhagen Denmark

8. Herlev‐Gentofte Hospital Herlev Denmark

9. GSK Collegeville PA

10. Perelman School of Medicine University of Pennsylvania Philadelphia PA

11. New York‐Presbyterian Hospital/Weill Cornell Medical Center New York NY

12. GSK Middlesex United Kingdom

13. Centre for Respiratory Medicine and Allergy Institute of Inflammation and Repair Manchester Academic Health Science Centre The University of Manchester Manchester University NHS Foundation Hospital Trust Manchester United Kingdom

14. Johns Hopkins University School of Medicine Baltimore MD

15. Minneapolis Veterans Affairs Health Care System University of Minnesota Twin Cities Medical School Minneapolis MN

Abstract

Background The association between chronic obstructive pulmonary disease exacerbations and increased cardiovascular event risk has not been adequately studied in a heterogenous population with both low and high cardiovascular risk. Methods and Results This post hoc analysis of the IMPACT (Informing the Pathway of COPD Treatment) trial (N=10 355 symptomatic patients with chronic obstructive pulmonary disease at risk of exacerbations) evaluated time‐dependent risk of cardiovascular adverse events of special interest (CVAESI) following exacerbations and impact of exacerbation history, cardiovascular risk factors, and study treatment on this association. Risk (time‐to‐first) of CVAESI or CVAESI resulting in hospitalization or death was assessed during and 1 to 30, 31 to 90, and 91 to 365 days after resolution of moderate or severe exacerbations. CVAESI risk was compared between the period before and during/after exacerbation. CVAESI risk increased significantly during a moderate (hazard ratio [HR], 2.63 [95% CI, 2.08–3.32]) or severe (HR, 21.84 [95% CI, 17.71–26.93]) exacerbation and remained elevated for 30 days following an exacerbation (moderate: HR, 1.63 [95% CI, 1.28–2.08]; severe: HR, 1.75 [95% CI, 0.99–3.11; nonsignificant]) and decreased over time, returning to baseline by 90 days. Risk of CVAESI resulting in hospitalization or death also increased during an exacerbation (moderate: HR, 2.46 [95% CI, 1.53–3.97]; severe: HR, 41.29 [95% CI, 30.43–56.03]) and decreased in a similar time‐dependent pattern. Results were consistent regardless of exacerbation history, cardiovascular risk at screening, or study treatment. Conclusions Overall risk of cardiovascular events was higher during and in the 30 days following chronic obstructive pulmonary disease exacerbations, even among those with low cardiovascular risk, highlighting the need for exacerbation prevention and vigilance for cardiovascular events following exacerbations. Registration URL: https://clinicaltrials.gov/ct2/show/NCT02164513 ; Unique identifier: NCT02164513

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Cardiology and Cardiovascular Medicine

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3