Long-term cardiovascular risk after severe exacerbation of COPD: a population-based cohort study

作者：Yinqi Ding, Jingcen Hu, Canqing Yu, Dianjianyi Sun, Pei Pei, Ling Yang, Yiping Chen, Huaidong Du, Zengzhi Zhang, Maxim Barnard, Junshi Chen, Zhengming Chen, Liming Li, Jun Lv · 发表于：ERJ Open Research · 年份：2025 · DOI：10.1183/23120541.00939-2025 · 被引用次数：2 · 研究领域：Chronic Obstructive Pulmonary Disease (COPD) Research、Respiratory and Cough-Related Research、Cardiovascular Health and Risk Factors

Background: Exacerbation of COPD (ECOPD) has been linked to increased cardiovascular disease (CVD) risk within the first year, yet longer term risk is unclear. We aimed to investigate the short-term and long-term CVD risks after severe ECOPD. Methods: Patients with self-reported or spirometry-detected COPD at baseline and patients with newly documented COPD during follow-up were included from the China Kadoorie Biobank. Multiple data sources were used to collect information on ECOPD hospitalisation and CVD incidence during follow-up. Time-dependent Cox regression models were used to estimate the hazard ratios and 95% confidence intervals for each risk period following ECOPD compared to the baseline period. Results: Of the 46 514 patients included, 48.2% had screen-detected COPD, 26.2% had self-reported COPD and 25.6% had newly documented COPD. During a median 11-year follow-up, 1185 acute myocardial infarction, 5778 other ischaemic heart disease, 1078 heart failure, 2390 pulmonary heart disease, 4989 ischaemic stroke and 1648 intracerebral haemorrhage cases occurred. Post-ECOPD risks of all outcomes were prominently elevated, with first-week hazard ratios (95% CI) of 8.60 (5.40-13.70), 6.68 (5.16-8.65), 10.98 (6.74-17.89), 24.76 (19.40-31.60), 3.11 (2.16-4.48) and 2.40 (1.27-4.54), respectively. The risks diminished thereafter but could persist for 6 years or longer. All three categories of patients with COPD faced increased risks of most outcomes, with patients with COPD at ...