Abstract
Objective:
To identify predictors of chronic obstructive pulmonary disease (COPD) severity and assess the relation between COPD severity and risk of cardiovascular outcomes.
Study design and setting:
A␣cohort of patients with diagnosed and treated COPD was compiled from the Saskatchewan Health longitudinal databases. We used multivariate modeling to identify predictors of hospitalization for COPD as an indicator of COPD severity, and we used the model to characterize patients according to quintiles of COPD severity. These severity levels were used as independent variables in multivariate models of cardiovascular outcomes.
Results:
Determinants of COPD severity included emphysema, recent nebulizer use, home oxygen services, corticosteroid use, frequent bronchodilator use, pneumonia and prior COPD exacerbation. The 20% of patients with the highest COPD severity were 1.27 (CI: 1.07–1.50) times more likely to have arrhythmia, 1.25 (CI: 1.07–1.46) times more likely to have ischemic heart disease, 1.38 (CI: 1.11–1.71) times more likely to have angina, 2.28 (CI: 1.95–2.66) times more likely to have congestive heart failure, and 1.63 (CI: 1.22–2.16) times more likely to die of cardiovascular causes than the least severe 20% of patients.
Conclusions:
Patients with more severe COPD, as defined by our model, had higher cardiovascular morbidity and mortality than patients with less severe COPD.
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Abbreviations
- COPD:
-
Chronic obstructive pulmonary disease
- GOLD:
-
Global initiative for chronic obstructive lung disease
- FEV:
-
Forced expiratory volume
- FEV1 :
-
Forced expiratory volume in one second
- PaO2 :
-
Arterial oxygen tension
- PaCO2 :
-
Arterial carbon dioxide tension
- BMI:
-
Body mass index
- ECG:
-
Electrocardiogram
- LVD:
-
Left ventricular dysfunction
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Acknowledgements
The authors would like to thank cardiologist Toby Barbey, M.D. for adjudication of medical charts and Miriam Gabrysh and Leanne Stricker for abstracting medical records at Saskatchewan hospitals.
Funding: This study was funded by Pfizer, Inc. and Boehringer-Ingelheim Pharmaceuticals. It is based in part on de-identified data provided by the Saskatchewan Department of Health. The interpretation and conclusions contained herein do not necessarily represent those of the Government of Saskatchewan or the Saskatchewan Department of Health.
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Curkendall, S.M., Lanes, S., de Luise, C. et al. Chronic obstructive pulmonary disease severity and cardiovascular outcomes. Eur J Epidemiol 21, 803–813 (2006). https://doi.org/10.1007/s10654-006-9066-1
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DOI: https://doi.org/10.1007/s10654-006-9066-1