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Cardiovascular outcomes in community-dwelling older adults with chronic obstructive pulmonary disease

Mitja Lainscak, Gerasimos Filippatos, Kanan Patel, Christine Ritchie, O. James Ekundayo, Chris Adamopoulos, Maciej Banach, Charity Morgan, Inmaculada Aban, Wilbert Aronow, Prakash Deedwania, Stefan Anker, Ali Ahmed
European Respiratory Journal 2013 42: P3443; DOI:
Mitja Lainscak
1Division of Cardiology, University Clinic Golnik, Golnik, Slovenia
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Gerasimos Filippatos
2Division of Cardiology, University of Athens, Athens, Greece
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Kanan Patel
3Division of Cardiology, University of Alabama at Birmingham, Birmingham, AL, United States
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Christine Ritchie
4Department of Cardiology, University of California, San Francisco, CA, United States
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O. James Ekundayo
5Division of Cardiology, Meharry Medical College, Nashville, TN, United States
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Chris Adamopoulos
6Division of Internal Medicine, Papageorgiou General Hospital, Thessaloniki, Greece
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Maciej Banach
7Department of General Medicine, Medical University of Lodz, Lodz, Poland
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Charity Morgan
3Division of Cardiology, University of Alabama at Birmingham, Birmingham, AL, United States
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Inmaculada Aban
3Division of Cardiology, University of Alabama at Birmingham, Birmingham, AL, United States
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Wilbert Aronow
8Department of Cardiology, New York Medical College, Valhalla, NY, United States
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Prakash Deedwania
4Department of Cardiology, University of California, San Francisco, CA, United States
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Stefan Anker
9Centre for Clinical and Basic Research, IRCCS San Raffaele, Rome, Italy
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Ali Ahmed
3Division of Cardiology, University of Alabama at Birmingham, Birmingham, AL, United States
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Abstract

Background: The association of chronic obstructive pulmonary disease (COPD) with incident cardiovascular (CV) events remains poorly defined. In the current study, we examined the association of COPD with long-term CV events in older adults.

Methods: Of the 5583 community-dwelling adults, age ≥65 years, in the Cardiovascular Health Study (CHS), 741 had COPD at baseline. We assembled three cohorts free of centrally-adjudicated baseline prevalent heart failure (HF; n=5326), acute myocardial infarction (AMI; n=5049) and stroke (n=5343) to estimate, respectively, age-sex-race-adjusted hazard ratios (aHR) and 95% confidence intervals (CI) for centrally-adjudicated incident HF, AMI and stroke over 13 years of follow-up. Multivariable (MV) adjusted HRs were estimated after additional adjustment for smoking, body mass index, prior AMI, hypertension, diabetes, stroke and atrial fibrillation.

Results: Participants had a mean age of 73 (±6) years, 57% were women and 15% were African American–all similarly distributed between the two groups. Incident HF occurred in 24% and 20% of participants with and without COPD respectively (aHR=1.37; 95% CI=1.16–1.61; p<0.001 and MV-adjusted HR=1.36; 95% CI=1.15–1.61; p<0.001). COPD was associated with higher incidence of AMI (14% vs. 11% in those without COPD; aHR=1.41; 95% CI=1.13–1.76; p=0.002) but not with stroke (14% each; aHR=1.12; 95% CI=0.91–1.39; p=0.291), with similar MV-adjusted HRs.

Conclusions: Community-dwelling older adults with COPD had higher risk for incident HF and AMI but not for stroke.

  • Comorbidities
  • Chronic disease
  • Elderly
  • © 2013 ERS
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Cardiovascular outcomes in community-dwelling older adults with chronic obstructive pulmonary disease
Mitja Lainscak, Gerasimos Filippatos, Kanan Patel, Christine Ritchie, O. James Ekundayo, Chris Adamopoulos, Maciej Banach, Charity Morgan, Inmaculada Aban, Wilbert Aronow, Prakash Deedwania, Stefan Anker, Ali Ahmed
European Respiratory Journal Sep 2013, 42 (Suppl 57) P3443;

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Cardiovascular outcomes in community-dwelling older adults with chronic obstructive pulmonary disease
Mitja Lainscak, Gerasimos Filippatos, Kanan Patel, Christine Ritchie, O. James Ekundayo, Chris Adamopoulos, Maciej Banach, Charity Morgan, Inmaculada Aban, Wilbert Aronow, Prakash Deedwania, Stefan Anker, Ali Ahmed
European Respiratory Journal Sep 2013, 42 (Suppl 57) P3443;
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