Tags

Type your tag names separated by a space and hit enter

Chronic Obstructive Pulmonary Disease as a Predictor of Cardiovascular Risk: A Case-Control Study.
COPD 2019; :1-9COPD

Abstract

Chronic obstructive pulmonary disease (COPD) is a complex multi-morbid disorder with significant cardiac mortality. Current cardiovascular risk prediction models do not include COPD. We investigated whether COPD modifies future cardiovascular risk to determine if it should be considered in risk prediction models.Case-control study using baseline data from two randomized controlled trials performed between 2012 and 2015. Of the 90 eligible subjects, 26 COPD patients with lung hyperinflation were propensity matched for 10-year global cardiovascular risk score (QRISK2) with 26 controls having normal lung function. Patients underwent cardiac magnetic resonance imaging, arterial stiffness and lung function measurements. Differences in pulse wave velocity (PWV), total arterial compliance (TAC) and aortic distensibility were main outcome measures.PWV (mean difference 1.0 m/s, 95% CI 0.02-1.92; p = 0.033) and TAC (mean difference -0.27 mL/m2/mmHg, 95% CI 0.39-0.15; p < 0.001) were adversely affected in COPD compared to the control group. The PWV difference equates to an age, sex and risk-factor adjusted increase in relative risk of cardiovascular events and mortality of 14% and 15%, respectively.There were no differences in aortic distensibility. In the whole cohort (n = 90) QRISK2 (β = 0.045, p = 0.005) was associated with PWV in multivariate analysis. The relationship between QRISK2 and PWV were modified by COPD, where the interaction term reached significance (p = 0.014). FEV1 (β = 0.055 (0.027), p = 0.041) and pulse (B = -0.006 (0.002), p = 0.003) were associated with TAC in multivariate analysis.Markers of cardiovascular outcomes are adversely affected in COPD patients with lung hyperinflation compared to controls matched for global cardiovascular risk. Cardiovascular risk algorithms may benefit from the addition of a COPD variable to improve risk prediction and guide management.HAPPY London ClinicalTrials.gov: NCT01911910 and HZC116601; ClinicalTrials.gov: NCT01691885.

Authors+Show Affiliations

Centre for Advanced Cardiovascular Imaging, NIHR Barts Biomedical Research Centre, William Harvey Research Institute, Queen Mary University London, London, UK. Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UK.Centre for Advanced Cardiovascular Imaging, NIHR Barts Biomedical Research Centre, William Harvey Research Institute, Queen Mary University London, London, UK. Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UK.Centre for Advanced Cardiovascular Imaging, NIHR Barts Biomedical Research Centre, William Harvey Research Institute, Queen Mary University London, London, UK. Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UK.Centre for Advanced Cardiovascular Imaging, NIHR Barts Biomedical Research Centre, William Harvey Research Institute, Queen Mary University London, London, UK. Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UK.Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UK. Global Respiratory Franchise, GlaxoSmithKline, London, UK.Centre for Advanced Cardiovascular Imaging, NIHR Barts Biomedical Research Centre, William Harvey Research Institute, Queen Mary University London, London, UK. Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UK.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31833441

Citation

Khanji, Mohammed Y., et al. "Chronic Obstructive Pulmonary Disease as a Predictor of Cardiovascular Risk: a Case-Control Study." COPD, 2019, pp. 1-9.
Khanji MY, Stone IS, Boubertakh R, et al. Chronic Obstructive Pulmonary Disease as a Predictor of Cardiovascular Risk: A Case-Control Study. COPD. 2019.
Khanji, M. Y., Stone, I. S., Boubertakh, R., Cooper, J. A., Barnes, N. C., & Petersen, S. E. (2019). Chronic Obstructive Pulmonary Disease as a Predictor of Cardiovascular Risk: A Case-Control Study. COPD, pp. 1-9. doi:10.1080/15412555.2019.1694501.
Khanji MY, et al. Chronic Obstructive Pulmonary Disease as a Predictor of Cardiovascular Risk: a Case-Control Study. COPD. 2019 Dec 13;1-9. PubMed PMID: 31833441.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Chronic Obstructive Pulmonary Disease as a Predictor of Cardiovascular Risk: A Case-Control Study. AU - Khanji,Mohammed Y, AU - Stone,Ian S, AU - Boubertakh,Redha, AU - Cooper,Jackie A, AU - Barnes,Neil C, AU - Petersen,Steffen E, Y1 - 2019/12/13/ PY - 2019/12/14/entrez PY - 2019/12/14/pubmed PY - 2019/12/14/medline KW - Cardiovascular risk KW - cardiovascular surrogate markers KW - pulse wave velocity KW - risk prediction models KW - surrogate markers SP - 1 EP - 9 JF - COPD JO - COPD N2 - Chronic obstructive pulmonary disease (COPD) is a complex multi-morbid disorder with significant cardiac mortality. Current cardiovascular risk prediction models do not include COPD. We investigated whether COPD modifies future cardiovascular risk to determine if it should be considered in risk prediction models.Case-control study using baseline data from two randomized controlled trials performed between 2012 and 2015. Of the 90 eligible subjects, 26 COPD patients with lung hyperinflation were propensity matched for 10-year global cardiovascular risk score (QRISK2) with 26 controls having normal lung function. Patients underwent cardiac magnetic resonance imaging, arterial stiffness and lung function measurements. Differences in pulse wave velocity (PWV), total arterial compliance (TAC) and aortic distensibility were main outcome measures.PWV (mean difference 1.0 m/s, 95% CI 0.02-1.92; p = 0.033) and TAC (mean difference -0.27 mL/m2/mmHg, 95% CI 0.39-0.15; p < 0.001) were adversely affected in COPD compared to the control group. The PWV difference equates to an age, sex and risk-factor adjusted increase in relative risk of cardiovascular events and mortality of 14% and 15%, respectively.There were no differences in aortic distensibility. In the whole cohort (n = 90) QRISK2 (β = 0.045, p = 0.005) was associated with PWV in multivariate analysis. The relationship between QRISK2 and PWV were modified by COPD, where the interaction term reached significance (p = 0.014). FEV1 (β = 0.055 (0.027), p = 0.041) and pulse (B = -0.006 (0.002), p = 0.003) were associated with TAC in multivariate analysis.Markers of cardiovascular outcomes are adversely affected in COPD patients with lung hyperinflation compared to controls matched for global cardiovascular risk. Cardiovascular risk algorithms may benefit from the addition of a COPD variable to improve risk prediction and guide management.HAPPY London ClinicalTrials.gov: NCT01911910 and HZC116601; ClinicalTrials.gov: NCT01691885. SN - 1541-2563 UR - https://www.unboundmedicine.com/medline/citation/31833441/Chronic_Obstructive_Pulmonary_Disease_as_a_Predictor_of_Cardiovascular_Risk:_A_Case-Control_Study L2 - http://www.tandfonline.com/doi/full/10.1080/15412555.2019.1694501 DB - PRIME DP - Unbound Medicine ER -