scholarly journals S100 Risk of cardiovascular morbidity and mortality in people with chronic obstructive pulmonary disease versus those without COPD: A structured review of the evidence

2021 ◽  
Author(s):  
H Müllerová ◽  
Z Marjenberg ◽  
J Marshall ◽  
E de Nigris ◽  
P Varghese ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Cardiovascular Morbidity ◽  
Morbidity And Mortality ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Cardiovascular Morbidity And Mortality

Chronic obstructive pulmonary disease: a novel risk factor for cardiovascular disease

2005 ◽  
Vol 83 (1) ◽  
pp. 8-13 ◽  
Author(s):  
Don D Sin ◽  
S.F Paul Man
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Cardiovascular Events ◽  
Cardiovascular Morbidity ◽  
Morbidity And Mortality ◽  
Health Study ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Cardiovascular Morbidity And Mortality

Chronic obstructive pulmonary disease (COPD) is one of the leading causes of morbidity and mortality in Canada and elsewhere. It affects 5% of all adult Canadians and is the fourth leading cause of death. Interestingly, the leading causes of hospitalizations and mortality among COPD patients are cardiovascular events. In the Lung Health Study, over 5 800 patients with mild to moderate COPD were studied. Forty-two to 48% of all hospitalizations that occurred over the study's 5-year follow-up period were related to cardiovascular complications. Various population-based studies suggest that independent of smoking, age, and gender, COPD increases the risk of cardiovascular morbidity and mortality twofold. Alarmingly, some bronchodilators, which are commonly used to treat symptoms in COPD, may increase the risk of cardiovascular morbidity and even mortality among COPD patients. In this paper, we discuss the epidemiologic evidence linking COPD and cardiovascular events as well as the potential mechanism(s) which may be responsible for this association.Key words: COPD, FEV1, cardiovascular events, C-reactive protein.

Acute Exacerbations of Chronic Obstructive Pulmonary Disease Are Accompanied by Elevations of Plasma Fibrinogen and Serum IL-6 Levels

2000 ◽  
Vol 84 (08) ◽  
pp. 210-215 ◽  
Author(s):  
Terence Seemungal ◽  
Peter MacCallum ◽  
Elizabeth Paul ◽  
Gavin Donaldson ◽  
Angshu Bhowmik ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Pulmonary Disease ◽  
Cardiovascular Morbidity ◽  
Plasma Fibrinogen ◽  
Morbidity And Mortality ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Cardiovascular Morbidity And Mortality

SummaryRespiratory tract infections may acutely increase risk from coronary heart disease (CHD), though the mechanisms have not been defined. Patients with chronic obstructive pulmonary disease (COPD) are prone to repeated exacerbations that are often associated with respiratory infections. These patients also have increased cardiovascular morbidity and mortality. We hypothesized that transient acute increases in plasma fibrinogen, an independent risk factor for CHD, could occur at COPD exacerbation (mediated through a rise in IL6) and thereby provide a mechanism linking respiratory infection to risk of coronary heart disease.93 COPD patients [mean (SD) age 66.8 (8.1) years] were followed regularly over one year, with daily diary card monitoring of respiratory symptoms and peak expiratory flow rate (PEFR); 67 patients [mean FEV1 1.06 (0.44) l, FVC 2.43 (0.79) l] were seen during 120 exacerbations. At each visit spirometry was measured and blood samples taken for plasma fibrinogen and Interleukin-6 (IL-6) levels.At baseline, the mean (SD) plasma fibrinogen was elevated at 3.9 (0.67) g/l in the 67 patients with exacerbations during the study and the median (IQR) IL-6 at 4.3 (2.4 to 6.8) pg/ml. Plasma fibrinogen increased by 0.36 (0.74) g/l at exacerbation (p <0.001), with IL-6 levels rising by 1.10 (−2.73 to 6.95) pg/ml (p = 0.008). There was a relation between the changes in fibrinogen at exacerbation and IL-6 levels (r = 0.348, p <0.001). Multiple regression revealed significantly greater rises in fibrinogen when exacerbations were associated with purulent sputum (b = 0.34 g/l; p = 0.03), increased cough (b = 0.31 g/l, p = 0.019) and symptomatic colds (b = 0.228; p = 0.024).Plasma fibrinogen levels were elevated in stable patients with COPD and may contribute to the increased cardiovascular morbidity and mortality in these patients. COPD exacerbations increased serum IL-6 levels, leading to a rise in plasma fibrinogen. Thus acute rather than chronic infection may have a role in predisposing to coronary heart disease or stroke.

scholarly journals Canadian Thoracic Society Recommendations for Management of Chronic Obstructive Pulmonary Disease – 2003

2003 ◽  
Vol 10 (suppl a) ◽  
pp. 11A-33A ◽  
Author(s):  
Denis E O’donnell ◽  
Shawn Aaron ◽  
Jean Bourbeau ◽  
Paul Hernandez ◽  
Darcy D Marciniuk ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Early Diagnosis ◽  
Pulmonary Disease ◽  
Management Strategies ◽  
Management Plan ◽  
Morbidity And Mortality ◽  
Chronic Obstructive ◽  
Activity Levels ◽  
Obstructive Pulmonary Disease ◽  
Comprehensive Management

Chronic obstructive pulmonary disease (COPD) is a common cause of disability and death in Canada. Moreover, morbidity and mortality from COPD continue to rise and the economic burden is enormous. The main goal of the Canadian Thoracic Society (CTS) Evidence-Based Guidelines is to optimize early diagnosis, prevention and management of COPD in Canada. Targeted spirometry is strongly recommended to expedite early diagnosis in smokers and exsmokers who develop respiratory symptoms, and who are at risk for COPD. Smoking cessation remains the single most effective intervention to reduce the risk of COPD and to slow its progression. Education, especially self-management plans, are key interventions in COPD. Therapy should be escalated in accordance with the increasing severity of symptoms and disability. Long acting anticholinergics and beta2-agonist inhalers should be prescribed for patients who remain symptomatic despite short-acting bronchodilator therapy. Inhaled steroids should not be used as first line therapy in COPD, but have a role in preventing exacerbations in patients with more advanced disease who suffer recurrent exacerbations. Management strategies consisting of combined modern pharmacotherapy and nonpharmacotherapeutic interventions (eg, pulmonary rehabilitation/exercise training) can effectively improve symptoms, activity levels, and quality of life, even in patients with severe COPD. Acute exacerbations of COPD cause significant morbidity and mortality and should be treated promptly with bronchodilators and a short course of oral steroids; antibiotics should be prescribed for purulent exacerbations. Patients with advanced COPD and respiratory failure require a comprehensive management plan that incorporates structured end-of-life care.

scholarly journals State of the Art Compendium: Canadian Thoracic Society Recommendations for Management of Chronic Obstructive Pulmonary Disease

2004 ◽  
Vol 11 (suppl b) ◽  
pp. 7B-59B ◽  
Author(s):  
Denis E O’Donnell ◽  
Shawn Aaron ◽  
Jean Bourbeau ◽  
Paul Hernandez ◽  
Darcy Marciniuk ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Early Diagnosis ◽  
Pulmonary Disease ◽  
Management Strategies ◽  
Management Plan ◽  
Morbidity And Mortality ◽  
Chronic Obstructive ◽  
Activity Levels ◽  
Obstructive Pulmonary Disease ◽  
Comprehensive Management

Chronic obstructive pulmonary disease (COPD) is a common cause of disability and death in Canada. Moreover, morbidity and mortality from COPD continue to rise, and the economic burden is enormous. The main goal of the Canadian Thoracic Society’s evidence-based guidelines is to optimize early diagnosis, prevention and management of COPD in Canada. The main message of the guidelines is that COPD is a preventable and treatable disease. Targeted spirometry is strongly recommended to expedite early diagnosis in smokers and former smokers who develop respiratory symptoms, and who are at risk for COPD. Smoking cessation remains the single most effective intervention to reduce the risk of COPD and to slow its progression. Education, especially self-management plans, are key interventions in COPD. Therapy should be escalated on an individual basis in accordance with the increasing severity of symptoms and disability. Long-acting anticholinergics and beta-2-agonist inhalers should be prescribed for patients who remain symptomatic despite short-acting bronchodilator therapy. Inhaled steroids should not be used as first line therapy in COPD, but have a role in preventing exacerbations in patients with more advanced disease who suffer recurrent exacerbations. Acute exacerbations of COPD cause significant morbidity and mortality and should be treated promptly with bronchodilators and a short course of oral steroids; antibiotics should be prescribed for purulent exacerbations. Patients with advanced COPD and respiratory failure require a comprehensive management plan that incorporates structured end-of-life care. Management strategies, consisting of combined modern pharmacotherapy and nonpharmacotherapeutic interventions (eg, pulmonary rehabilitation and exercise training) can effectively improve symptoms, activity levels and quality of life, even in patients with severe COPD.

scholarly journals High resolution computed tomography in chronic obstructive pulmonary disease

2018 ◽  
Vol 5 (5) ◽  
pp. 1222
Author(s):  
Pragati Rao D. ◽  
Aruna Talatam ◽  
Chakradhar B. ◽  
Bhargavi K. ◽  
Bhagyaraj A.
Keyword(s):  
Computed Tomography ◽  
Chronic Obstructive Pulmonary Disease ◽  
High Resolution ◽  
Pulmonary Disease ◽  
Morbidity And Mortality ◽  
Chronic Obstructive ◽  
X Rays ◽  
High Resolution Computed Tomography ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients

Background: Chronic obstructive pulmonary disease (COPD) is a common preventable and treatable disease characterised by persistent respiratory symptoms and airflow limitation with varied presentations (bronchitis and emphysema). High resolution computed tomography (HRCT) plays an important role in identifying the various morphologies thereby reducing morbidity and mortality. The aim of the present study was to evaluate the role of high resolution computed tomography in COPD patients. The Objectives of the present study was to differentiate emphysema predominant, airway predominant and mixed phenotypes and to identify other disease processes and complications.Methods: 50 COPD patients attending Respiratory medicine Department, NRI general hospital were advised for chest x-rays and pulmonary function tests. All the patients selected were smokers with no other co-morbid illnesses. Those patients whose chest x-rays showed no other changes except for COPD changes were selected for HRCT chest.Results: Out of 50 COPD patients emphysema predominance was present in 28 patients (56%), bronchitis predominance in 19 patients (38%) and 3(6%) patients had mixed pattern. In emphysema centriacinar pattern was commonly seen (42.9%), paraseptal in 35.71%, panacinar in 3.57% and bullae in 17.8% cases. All the patients were chronic smokers with pack years >20. All are males with average age above 45 years. Emphysema was common in elderly patients with age above 50 years. Chronic bronchitis is predominantly seen in the age group 40-50 years. Additional diagnoses like bronchiectasis, mass, ILD were identified in 28% cases.Conclusions: HRCT plays a significant role in COPD patients in differentiating phenotypes which have different modes of therapy. Other subtle changes in lungs which cannot be identified on chest x ray are discernible on HRCT. Early identification of complications reduces morbidity and mortality.

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