A retrospective study on chronic obstructive pulmonary disease severity and cardiovascular comorbidities

    Authors

    Abstract

    **Introduction**: Chronic obstructive pulmonary disease (COPD) is a global health issue characterized by progressive airflow limitation and respiratory symptoms (1, 2). Recent research have shown that patients with COPD often have a higher prevalence of cardiovascular diseases (CVD), including hypertension, coronary artery disease, and congestive heart failure (3, 4). This retrospective study aims to compare prevalence of CVD based on COPD severity. **Patients and Methods**: Data were collected from patients with COPD attending Pulmonology Clinic between April 2023, and October 2023. We divided patients into Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages I or II (FEV1 >50%) and GOLD stages III or IV (FEV1 0.9 | | | No | 19 (33.9) | 18 (34.0) | 37 (33.9) | | | | | Long-term oxygen therapy | | | | | | | | Yes | 1 (1.8) | 10 (18.9) | 11 (10.1) | | **0.003** | | | No | 55 (98.2) | 43 (81.1) | 98 (89.9) | | | | | Current smoking | | | | | | | | Yes | 27 (48.2) | 17 (32.1) | 44 (40.4) | | 0.1 | | | No | 29 (51.8) | 36 (67.9) | 65 (59.6) | | | | | Exacerbation of COPD over the one year-period | | | | | | | | Yes | 15 (26.8) | 33 (62.3) | 48 (44.0) | | **<0.001** | | | No | 41 (73.2) | 20 (37.7) | 61 (56.0) | | | | [†] COPD = Chronic obstructive pulmonary disease; GOLD = Global Initiative for Chronic Obstructive Lung Disease; * Fisher’s Exact Test FIGURE 1. Comorbidities and cardiovascular diseases among patients depending on the severity of chronic obstructive pulmonary disease. FIGURE 2. The difference in the choice of therapy depending on the GOLD stage (Fisher’s Exact Test). IC = inhaled corticosteroid; LAMA = long-acting muscarinic antagonist; LABA = long-acting β2 agonist; SAMA = short-acting muscarinic antagonist; SABA= short-acting β2 agonist; SS = SAMA+SABA; LL = LAMA+LABA; IL = IC+LABA; ILL = IC+LAMA+LABA. FIGURE 3. The distribution of the use of cardiovascular therapy between Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage I or II and GOLD stage III or IV groups. BP = blood pressure medication; BB = beta-blockers; CLM = cholesterol-lowering medication, AT = anticoagulant therapy; ASA = aspirin; CG = cardiac glycosides; AA = aldosterone antagonists; D = diuretics. **Conclusion**: Despite prior research, we could not confirm the COPD severity-CVD link. Further research is vital to emphasize the need for personalized care, considering the limitation of a small patient sample.

    Keywords

    chronic obstructive pulmonary disease, cardiovascular diseases, therapy exacerbation

    DOI

    https://doi.org/10.15836/ccar2024.114

    Literature

    1. Christenson SA, Smith BM, Bafadhel M, Putcha N. Chronic obstructive pulmonary disease. Lancet. 2022 June 11;399(10342):2227–42. https://doi.org/10.1016/S0140-6736(22)00470-6
    2. Agarwal AK, Raja A, Brown BD. Chronic Obstructive Pulmonary Disease. 2023 Aug 7. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. https://pubmed.ncbi.nlm.nih.gov/32644707/
    3. Trinkmann F, Saur J, Borggrefe M, Akin I. Cardiovascular Comorbidities in Chronic Obstructive Pulmonary Disease (COPD)-Current Considerations for Clinical Practice. J Clin Med. 2019 January 10;8(1):69. https://doi.org/10.3390/jcm8010069
    4. Balbirsingh V, Mohammed AS, Turner AM, Newnham M. Cardiovascular disease in chronic obstructive pulmonary disease: a narrative review. Thorax. 2022 Jun 30:thoraxjnl-2021-218333. Epub ahead of print. https://doi.org/10.1136/thoraxjnl-2021-218333
    Cardiologia Croatica
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    A retrospective study on chronic obstructive pulmonary disease severity and cardiovascular comorbidities

    Extended Abstract
    Issue3-4
    Published
    Pages114-115
    PDF via DOIhttps://doi.org/10.15836/ccar2024.114
    chronic obstructive pulmonary disease
    cardiovascular diseases
    therapy exacerbation

    Authors

    Ana Kovačević*ORCIDGeneral Hospital “Dr. Josip Benčević”, Slavonski Brod, Croatia
    Stjepan KovačevićORCIDGeneral Hospital “Dr. Josip Benčević”, Slavonski Brod, Croatia
    Iva DumančićORCIDGeneral Hospital “Dr. Josip Benčević”, Slavonski Brod, Croatia
    Maja FranićORCIDGeneral Hospital “Dr. Josip Benčević”, Slavonski Brod, Croatia
    Josipa MeterORCIDGeneral Hospital “Dr. Josip Benčević”, Slavonski Brod, Croatia
    Nikolina BukalORCIDGeneral Hospital “Dr. Josip Benčević”, Slavonski Brod, Croatia
    Ninoslav LekoORCIDGeneral Hospital “Dr. Josip Benčević”, Slavonski Brod, Croatia
    Blaženka MiškićORCIDGeneral Hospital “Dr. Josip Benčević”, Slavonski Brod, Croatia
    Katica Cvitkušić LukendaORCIDGeneral Hospital “Dr. Josip Benčević”, Slavonski Brod, Croatia

    *Correspondence email: ana.bardak@gmail.com

    Abstract

    **Introduction**: Chronic obstructive pulmonary disease (COPD) is a global health issue characterized by progressive airflow limitation and respiratory symptoms (1, 2). Recent research have shown that patients with COPD often have a higher prevalence of cardiovascular diseases (CVD), including hypertension, coronary artery disease, and congestive heart failure (3, 4). This retrospective study aims to compare prevalence of CVD based on COPD severity. **Patients and Methods**: Data were collected from patients with COPD attending Pulmonology Clinic between April 2023, and October 2023. We divided patients into Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages I or II (FEV1 >50%) and GOLD stages III or IV (FEV1 0.9 | | | No | 19 (33.9) | 18 (34.0) | 37 (33.9) | | | | | Long-term oxygen therapy | | | | | | | | Yes | 1 (1.8) | 10 (18.9) | 11 (10.1) | | **0.003** | | | No | 55 (98.2) | 43 (81.1) | 98 (89.9) | | | | | Current smoking | | | | | | | | Yes | 27 (48.2) | 17 (32.1) | 44 (40.4) | | 0.1 | | | No | 29 (51.8) | 36 (67.9) | 65 (59.6) | | | | | Exacerbation of COPD over the one year-period | | | | | | | | Yes | 15 (26.8) | 33 (62.3) | 48 (44.0) | | **<0.001** | | | No | 41 (73.2) | 20 (37.7) | 61 (56.0) | | | | [†] COPD = Chronic obstructive pulmonary disease; GOLD = Global Initiative for Chronic Obstructive Lung Disease; * Fisher’s Exact Test FIGURE 1. Comorbidities and cardiovascular diseases among patients depending on the severity of chronic obstructive pulmonary disease. FIGURE 2. The difference in the choice of therapy depending on the GOLD stage (Fisher’s Exact Test). IC = inhaled corticosteroid; LAMA = long-acting muscarinic antagonist; LABA = long-acting β2 agonist; SAMA = short-acting muscarinic antagonist; SABA= short-acting β2 agonist; SS = SAMA+SABA; LL = LAMA+LABA; IL = IC+LABA; ILL = IC+LAMA+LABA. FIGURE 3. The distribution of the use of cardiovascular therapy between Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage I or II and GOLD stage III or IV groups. BP = blood pressure medication; BB = beta-blockers; CLM = cholesterol-lowering medication, AT = anticoagulant therapy; ASA = aspirin; CG = cardiac glycosides; AA = aldosterone antagonists; D = diuretics. **Conclusion**: Despite prior research, we could not confirm the COPD severity-CVD link. Further research is vital to emphasize the need for personalized care, considering the limitation of a small patient sample.

    Literature

    1. 1.
      Christenson SA, Smith BM, Bafadhel M, Putcha N. Chronic obstructive pulmonary disease. Lancet. 2022 June 11;399(10342):2227–42.DOI
    2. 2.
      Agarwal AK, Raja A, Brown BD. Chronic Obstructive Pulmonary Disease. 2023 Aug 7. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–.PubMed
    3. 3.
      Trinkmann F, Saur J, Borggrefe M, Akin I. Cardiovascular Comorbidities in Chronic Obstructive Pulmonary Disease (COPD)-Current Considerations for Clinical Practice. J Clin Med. 2019 January 10;8(1):69.DOI
    4. 4.
      Balbirsingh V, Mohammed AS, Turner AM, Newnham M. Cardiovascular disease in chronic obstructive pulmonary disease: a narrative review. Thorax. 2022 Jun 30:thoraxjnl-2021-218333. Epub ahead of print.DOI