Abstract
Whilst cardiovascular comorbidity is prevalent in COPD and COPD exacerbations are associated with acute cardiac risk, it is unclear how a history of cardiovascular comorbidity affects exacerbation risk.
The prospective, observational ACCESS study (Assessment of Comorbidities in COPD in European Symptomatic Subjects) from primary care In 6 European countries) was powered to compare the rate of exacerbations in COPD patients with or without cardiovascular disease (CVD) over 24 months. The definition of CVD has been previously reported (Vestbo J, et al. Eur Respir J 2013; 41:1017).
At baseline, CVD patients were older and more likely to be ex-smokers, but had similar levels of COPD severity. Annualised rates of moderate/severe exacerbations and hospital admissions adjusted for important COPD indicators did not differ by CVD status.
With CVD (N=1375) | Without CVD (N=1512) | |
Age (years), mean (SD) | 70 (8.7) | 63 (9.9) |
Male, n (%) | 1050 (77) | 964 (64) |
BMI, mean (SD) | 28 (5.1) | 26 (5.3) |
Current smoker, n (%) | 534 (39) | 820 (54) |
Post-bronchodilator FEV1 % pred, mean (SD) | 59 (19.1) | 60 (19.8) |
CAT score at baseline, mean (SD) | 15.6 (7.65) | 14.5 (7.73) |
Moderate/severe COPD exacerbations at 24 months | ||
Annual rate per person (95% CI) adjusted¥ | 0.63 (0.57, 0.69) | 0.63 (0.58, 0.69) |
Rate ratio (95% CI)¥ | 0.99 (0.88, 1.11) | |
COPD hospital admissions at 24 months | ||
Annual rate per person (95% CI) adjusted¥ | 0.05 (0.04, 0.06) | 0.04 (0.04, 0.06) |
Rate ratio (95% CI)¥ | 1.14 (0.87, 1.50) |
¥negative binomial model adjusted for age, gender, smoking status, post-bronchodilator % predicted FEV1, CAT score, country
We conclude that there is no association between CVD and risk of COPD exacerbations.
GSK-funded study HZC115058; NCT01516528.
- Copyright ©ERS 2015