scholarly journals Maintenance Therapy in Patients with FLT3-ITD-Mutation-Positive Acute Myeloid Leukemia after Allogeneic Hematopoietic Cell Transplantation: Real-World Survival

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 693-693
Author(s):  
Hongbo Yang ◽  
Yan Song ◽  
James D. Griffin ◽  
Manasee V. Shah ◽  
Jonathan Freimark ◽  
...  
Keyword(s):  
Maintenance Therapy ◽  
Regression Model ◽  
Real World ◽  
Myeloid Leukemia ◽  
Index Date ◽  
Cox Regression ◽  
Cox Regression Model ◽  
Allogeneic Hsct ◽  
Kaplan Meier ◽  
Allelic Burden

Abstract Background: Patients with FLT3-mutation-positive (FLT3mut+) acute myeloid leukemia (AML) have a poor prognosis, particularly those with a high allelic burden of FLT3-ITD mutations (FLT3-ITD mut+). Further, patients with FLT3-ITD mut+ who have relapsed after allogeneic hematopoietic stem cell transplantation (HSCT) have a 1-year overall survival (OS) rate of less than 20%. While treatment guidelines vary in their recommendations for maintenance therapy after HSCT to prevent relapse, data are emerging on the potential benefits of maintenance therapy for patients with FLT3mut+ AML. Aim/Objective: To examine real-world survival outcomes in adult patients with FLT3-ITD mut+ AML who received maintenance therapy versus those who did not receive maintenance therapy after allogeneic HSCT, including a qualitative comparison with real-world survival outcomes in adults with FLT3mut+ AML. Methods: This was a retrospective chart review wherein hematologists and oncologists from North America, Europe, and Japan extracted data from the medical charts of patients with FLT3mut+ AML who underwent HSCT after achieving complete remission with first-line chemotherapy within the prior 3 years. The index date was the date of HSCT and the study period was from the index date to the date of the last follow-up or death. All patients were grouped into two cohorts based on post-HSCT therapy received (no maintenance therapy or maintenance therapy). In an analysis of a subgroup of patients typically considered to be at high risk of relapse, patients who had both received an allogeneic HSCT and had a high allelic burden of FLT3-ITD mut+ were analyzed; patients with FLT3-ITD and FLT3-TKD co-mutations were also included in this subgroup. Overall survival during the study period was assessed for each cohort in the overall population of patients and in the subgroup. Kaplan-Meier analyses and Cox regression models, including unadjusted models and models with adjustments for baseline covariates, were used to describe and evaluate cross-cohort comparisons of survival. Covariates in the adjusted Cox models were Eastern Cooperative Oncology Group status, risk status, measurable residual disease status, age at index date, sex, extramedullary involvement, race, BMI, time from diagnosis to index month, HSCT type, and country. Results: A total of 1,208 AML patients with FLT3mut+ who received HSCT were included in the general study population; 765 (63.3%) patients received no maintenance therapy and 443 (36.7%) patients received maintenance therapy (including FLT3 inhibitors, hypomethylating agents, cytotoxic chemotherapy, and other targeted therapies). In Kaplan-Meier analyses, OS was longer in patients who received maintenance therapy compared with those who did not receive maintenance therapy (log-rank P<0.001; Figure A). Similar results were seen between maintenance therapy versus no maintenance therapy in an unadjusted Cox regression model (HR 0.52 [95% CI 0.35, 0.76], P<0.001) and adjusted Cox regression model (HR 0.48 [95% CI 0.30, 0.77], P<0.01). In an analysis of the subgroup, data from the charts of 745 patients with FLT3-ITD mut+ who received allogeneic HSCT were reviewed. The mean age at HSCT was 53.2 years; 39.9% and 38.4% of patients had intermediate and poor risk status, respectively. Of this subgroup, 473 (63.5%) patients received no maintenance therapy and 272 (36.5%) patients received maintenance therapy. Kaplan-Meier analyses show that OS was longer in patients receiving maintenance therapy versus no maintenance therapy (log-rank P<0.001; Figure B); the risk of death appeared to plateau after approximately 2 years in patients receiving maintenance treatments. Similar results were seen between maintenance therapy versus no maintenance therapy in an unadjusted Cox regression model (HR 0.39 [95% CI 0.23, 0.65], P<0.001) and adjusted Cox regression model (HR 0.38 [95% CI 0.20, 0.72], P<0.01). Conclusions: In patients with FLT3-ITD mut+ AML, OS was improved in patients that received any type of maintenance therapy compared with patients that received no maintenance therapy after allogeneic HSCT. These improved clinical outcomes in a high-risk subgroup receiving maintenance treatments are consistent with findings in the general population of patients with FLT3mut+ AML. Additional analyses are warranted to statistically verify these results. Figure 1 Figure 1. Disclosures Yang: Astellas Pharma, Inc.: Consultancy. Song: Astellas Pharma, Inc.: Consultancy. Griffin: Astellas Pharma, Inc.: Consultancy; Novartis: Patents & Royalties: Post marketing royalties from midostaurin. Shah: Astellas Pharma, Inc.: Current Employment; University of Michigan School of Public Health Department of Health Management and Policy Alumni Board: Other: Chair-Elect. Freimark: Astellas Pharma, Inc.: Consultancy. Chilelli: Astellas Pharma, Inc.: Current Employment.

scholarly journals Cox proportion hazard model for patients with hepatitis disease in Iraq

2009 ◽  
Vol 6 (3) ◽  
pp. 612-617
Author(s):  
Baghdad Science Journal
Keyword(s):  
Regression Model ◽  
Survival Time ◽  
Cox Regression ◽  
Survival Function ◽  
Hazard Model ◽  
Cox Regression Model ◽  
Hepatic Diseases ◽  
Kaplan Meier

Cox regression model have been used to estimate proportion hazard model for patients with hepatitis disease recorded in Gastrointestinal and Hepatic diseases Hospital in Iraq for (2002 -2005). Data consists of (age, gender, survival time terminal stat). A Kaplan-Meier method has been applied to estimate survival function and hazerd function.

Can Systemic Immune-Inflammation Index Create a New Perspective for the IMDC Scoring System in Patients with Metastatic Renal Cell Carcinoma?

2021 ◽  
pp. 1-8
Author(s):  
Fatma Bugdayci Basal ◽  
Cengiz Karacin ◽  
Irem Bilgetekin ◽  
Omur Berna Oksuzoglu
Keyword(s):  
Renal Cell Carcinoma ◽  
Prognostic Factor ◽  
Regression Model ◽  
Cell Carcinoma ◽  
Metastatic Renal Cell Carcinoma ◽  
Renal Cell ◽  
Cox Regression ◽  
Independent Prognostic Factor ◽  
Cox Regression Model ◽  
Kaplan Meier

Introduction: The aim of the study was to evaluate impact of the systemic immune-inflammation index (SII) on prognosis and survival within the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) score groups. Methods: The records of 187 patients with metastatic renal cell carcinoma (RCC) were reviewed retrospectively. The SII was calculated as follows: SII = Neutrophil × Platelet/Lymphocyte. The patients were categorized into 2 groups based on a median SII of 730 (×109 per 1 L) as SII low (<730) and SII high (≥730). The Kaplan-Meier method was used for survival analysis and a Cox regression model was utilized to determine independent predictors of survival. Results: The median age was 61 years (range: 34–86 years). Kaplan-Meier tests revealed significant differences in survival between the SII-low and SII-high levels (27.0 vs. 12.0 months, respectively, p < 0.001). The Cox regression model revealed that SII was an independent prognostic factor. The implementation of the log-rank test in the IMDC groups according to the SII level provided the distinction of survival in the favorable group (SII low 49.0 months vs. SII high 11.0 months, p < 0.001), in the intermediate group (SII low 26.0 vs. SII high 15.0 months, p = 0.007), and in the poor group (SII low 19.0 vs. SII high 6.0 months, p = 0.019). Conclusion: The SII was an independent prognostic factor and provided significant differences in survival for the favorable, intermediate, and poor IMDC groups. Thus, the SII added to the IMDC score may be clinically beneficial in predicting survival.

scholarly journals 551. Remdesivir and Tocilizumab for the Treatment of Severe COVID-19 in a Community Hospital: A Retrospective Cohort Study

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S378-S379
Author(s):  
Guillermo Rodriguez-Nava ◽  
Goar Egoryan ◽  
Daniela Patricia Trelles-Garcia ◽  
Maria Adriana Yanez-Bello ◽  
Qishuo Zhang ◽  
...  
Keyword(s):  
Regression Model ◽  
Community Hospital ◽  
Cox Regression ◽  
Hazard Ratio ◽  
Rank Test ◽  
Hospital Death ◽  
P Value ◽  
Survival Curves ◽  
Cox Regression Model ◽  
Kaplan Meier

Abstract Background Growing evidence supports the use of remdesivir and tocilizumab for the treatment of hospitalized patients with severe COVID-19. The purpose of this study was to evaluate the use of remdesivir and tocilizumab for the treatment of severe COVID-19 in a community hospital setting. Methods We used a de-identified dataset of hospitalized adults with severe COVID-19 according to the National Institutes of Health definition (SpO2 &lt; 94% on room air, a PaO2/FiO2 &lt; 300 mm Hg, respiratory frequency &gt; 30/min, or lung infiltrates &gt; 50%) admitted to our community hospital located in Evanston Illinois, between March 1, 2020, and March 1, 2021. We performed a Cox proportional hazards regression model to examine the relationship between the use of remdesivir and tocilizumab and inpatient mortality. To minimize confounders, we adjusted for age, qSOFA score, noninvasive positive-pressure ventilation, invasive mechanical ventilation, and steroids, forcing these variables into the model. We implemented a sensitivity analysis calculating the E-value (with the lower confidence limit) for the obtained point estimates to assess the potential effect of unmeasured confounding. Figure 1. Kaplan–Meier survival curves for in-hospital death among patients treated with and without steroids The hazard ratio was derived from a bivariable Cox regression model. The survival curves were compared with a log-rank test, where a two-sided P value of less than 0.05 was considered statistically significant. Figure 2. Kaplan–Meier survival curves for in-hospital death among patients treated with and without remdesivir The hazard ratio was derived from a bivariable Cox regression model. The survival curves were compared with a log-rank test, where a two-sided P value of less than 0.05 was considered statistically significant. Results A total of 549 patients were included. The median age was 69 years (interquartile range, 59 – 80 years), 333 (59.6%) were male, 231 were White (41.3%), and 235 (42%) were admitted from long-term care facilities. 394 (70.5%) received steroids, 192 (34.3%) received remdesivir, and 49 (8.8%) received tocilizumab. By the cutoff date for data analysis, 389 (69.6%) patients survived, and 170 (30.4%) had died. The bivariable Cox regression models showed decreased hazard of in-hospital death associated with the administration of steroids (Figure 1), remdesivir (Figure 2), and tocilizumab (Figure 3). This association persisted in the multivariable Cox regression controlling for other predictors (Figure 4). The E value for the multivariable Cox regression point estimates and the lower confidence intervals are shown in Table 1. Figure 3. Kaplan–Meier survival curves for in-hospital death among patients treated with and without tocilizumab The hazard ratio was derived from a bivariable Cox regression model. The survival curves were compared with a log-rank test, where a two-sided P value of less than 0.05 was considered statistically significant. Figure 4. Forest plot on effect estimates and confidence intervals for treatments The hazard ratios were derived from a multivariable Cox regression model adjusting for age as a continuous variable, qSOFA score, noninvasive positive-pressure ventilation, and invasive mechanical ventilation. Table 1. Sensitivity analysis of unmeasured confounding using E-values CI, confidence interval. Point estimate from multivariable Cox regression model. The E value is defined as the minimum strength of association on the risk ratio scale that an unmeasured confounder would need to have with both the exposure and the outcome, conditional on the measured covariates, to explain away a specific exposure-outcome association fully: i.e., a confounder not included in the multivariable Cox regression model associated with remdesivir or tocilizumab use and in-hospital death in patients with severe COVID-19 by a hazard ratio of 1.64-fold or 1.54-fold each, respectively, could explain away the lower confidence limit, but weaker confounding could not. Conclusion For patients with severe COVID-19 admitted to our community hospital, the use of steroids, remdesivir, and tocilizumab were significantly associated with a slower progression to in-hospital death while controlling for other predictors included in the models. Disclosures All Authors: No reported disclosures

P4777Mortality in patients with non-valvular atrial fibrillation in South America. Warfarin has significant higher global mortality rates versus dabigatran and rivaroxaban

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M J Arocena ◽  
G Vanerio
Keyword(s):  
Atrial Fibrillation ◽  
Regression Model ◽  
Cause Of Death ◽  
Cox Regression ◽  
Oral Anticoagulants ◽  
Total Mortality ◽  
Mortality Rates ◽  
Cox Regression Model ◽  
Kaplan Meier ◽  
Direct Anticoagulants

Abstract Background Oral anticoagulants are the cornerstone for the management of atrial fibrillation (AF) to reduce cardioembolic stroke Randomized controlled trials of anticoagulants have shown non-inferiority of direct oral anticoagulants (DOACs) compared to warfarin Most DOACs represent an advance in therapeutic safety when compared to warfarin for prevention of thromboembolism in patients with AF. Objectives Determine long term survival, total mortality rates and mortality cause between patients with non-valvular atrial fibrillation (AF) receiving anticoagulants (warfarin, dabigatran and rivaroxaban) Methods Retrospective analysis of consecutive patients with AF receiving anticoagulants in two Hospitals in Montevideo, using electronic registries. Demographics, co-morbidities, CHA2DS2VASc scores and mortality cause were annotated. Follow-up started on Jan 2011 and finished on Dec 2017. Anticoagulation quality was expressed as the standard deviation of INRs (SD-INRs). We performed global mortality and mortality cause analysis on patients with anti-VitK versus direct anticoagulants. Statistical analysis: Survival analysis was performed using Kaplan-Meier (log rank) and Cox regression model. All differences between groups were considered significant if the p value was <0.001. Results We studied 4501 pts., 3627 patients were on warfarin (80.6%), 456 (10.1%) were on dabigatran and 418 (9.3%) on rivaroxaban. Those receiving direct anticoagulants were older, 79±9 vs 77±11 years, (p=0.0001), 51.3% were female, with a significantly higher prevalence of HTN; 93.7% vs 88.8% and a CHA2DS2VASc score ≥2 (96% vs 91%), and a lower prevalence of CHD (5.8% vs 10.4%), CHF (3.7% vs 9.5%) and CKD (2.3% vs 6.3%).Total mortality was 818 (18%); patients receiving warfarin had significantly higher mortality rates, 727 (20.1%) vs 91 (10.4%); 63 and 28 (13.8%, 6.7% dabigatran and rivaroxaban respectively) Kaplan-Meier curves were significantly different (Figure 1) showing higher survival rates for those on DOACs. The SD-INRs were 0.85±0.47 (n=1726 alive) vs 1.05±0.46 (n=548 dead), mean difference 0.2 (99% CI 0.14–0.26). Mortality could be analysed in 759 patients (92,7%). The most important cause of death was cardiovascular disease in 26.5%. We could not find significant differences in the cause of death between groups. Using Cox regression model, variables with significant increased mortality were HTN, CHD, CHF, CKD and history of previous CVA. The only variable with a significant decrease in mortality was the use of dabigatran or rivaroxaban; HR 0.55 (95% CI 0.44–0.69) Figure 1 Conclusions In this large cohort of patients, those receiving warfarin have significantly higher mortality rates. Mortality differences were not related to stroke or major bleeding but could be explained by a higher prevalence of CHD, CHF and CKD in the warfarin group despite a significant lower CHA2DS2VASc score.

scholarly journals KESINTASAN PASIEN LEUKEMIA LIMFOBLASTIK AKUT PADA ANAK DI RSUP.DR.WAHIDIN SUDIROHUSODO MAKASSAR

2019 ◽  
Vol 1 (3) ◽  
Author(s):  
Rezki Elisafitri ◽  
A. Arsunan Arsin ◽  
Atjo Wahyu
Keyword(s):  
Regression Model ◽  
Cox Regression ◽  
Cox Regression Model ◽  
Kaplan Meier

Leukemia Limfoblastik Akut (LLA) merupakan salah satu keganasan hematologi yang paling banyak dideritaoleh anak-anak. Tolak ukur keberhasilan pengobatan pada pasien leukemia dapat dilihat berdasarkan angkakesintasan. Penelitian ini bertujuan mengetahui proporsi kesintasan pasien LLA pada anak di RSUP Dr.WahidinSudirohusodo dan faktor prognosis yang mempengaruhinya. Penelitian ini menggunakan desain studiobservasional analitik dengan rancangan kohort retrospektif. Sampel pada penelitian ini adalah pasien LLA yangdidiagnosis tahun 2014-2017 di RSUP Dr.Wahidin Sudirohusodo. Sebanyak 109 pasien dipilih secara simplerandom sampling. Data penelitian dikumpulkan dengan melakukan penelusuran rekam medik pasien. Datadianalisis menggunakan analisis Kaplan-Meier dan Cox Regression. Hasil penelitian menunjukkan bahwaproporsi kesintasan 48 bulan pasien LLA pada anak di RSUP Dr. Wahidin Sudirohusodo Makassar sebesar 26%.Faktor prognosis yang berhubungan secara statistik dengan kesintasan pasien LLA adalah status gizi (p=0,028),sedangkan umur dan jenis kelamin tidak berhubungan dengan kesintasan pasien LLA (p>0,05). Berdasarkananalisis multivariat dengan cox regression model interaksi, faktor prognosis yang paling berpengaruh terhadapkesintasan pasien LLA adalah status gizi (p=0,040; HR=1,739 CI 95% 1,024-2,952). Pasien LLA dengan statusgizi abnormal memiliki risiko kematian 1,739 kali lebih tinggi dibandingkan pasien LLA dengan status gizinormal.

scholarly journals Outcome of Acute Prosthetic Joint Infections Due to Gram-Negative Bacilli Treated with Open Debridement and Retention of the Prosthesis

2009 ◽  
Vol 53 (11) ◽  
pp. 4772-4777 ◽  
Author(s):  
Juan C. Martínez-Pastor ◽  
Ernesto Muñoz-Mahamud ◽  
Félix Vilchez ◽  
Sebastián García-Ramiro ◽  
Guillem Bori ◽  
...  
Keyword(s):  
Regression Model ◽  
Cox Regression ◽  
Oral Antibiotic ◽  
Cox Regression Model ◽  
Gram Negative ◽  
Joint Infections ◽  
Kaplan Meier ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections ◽  
Open Debridement

ABSTRACT The aim of our study was to evaluate the outcome of acute prosthetic joint infections (PJIs) due to gram-negative bacilli (GNB) treated without implant removal. Patients with an acute PJI due to GNB diagnosed from 2000 to 2007 were prospectively registered. Demographics, comorbidity, type of implant, microbiology data, surgical treatment, antimicrobial therapy, and outcome were recorded. Classification and regression tree analysis, the Kaplan-Meier survival method, and the Cox regression model were applied. Forty-seven patients were included. The mean age was 70.7 years, and there were 15 hip prostheses and 32 knee prostheses. The median number of days from the time of arthroplasty was 20. The most frequent pathogens were members of the Enterobacteriaceae family in 41 cases and Pseudomonas spp. in 20 cases. Among the Enterobacteriaceae, 14 were resistant to ciprofloxacin, while all Pseudomonas aeruginosa isolates were susceptible to ciprofloxacin. The median durations of intravenous and oral antibiotic treatment were 14 and 64 days, respectively. A total of 35 (74.5%) patients were in remission after a median follow-up of 463 days (interquartile range, 344 to 704) days. By use of the Kaplan-Meier survival curve, a C-reactive protein (CRP) concentration of ≤15 mg/dl (P = 0.03) and receipt of a fluoroquinolone, when all GNB isolated were susceptible (P = 0.0009), were associated with a better outcome. By use of a Cox regression model, a CRP concentration of ≤15 mg/dl (odds ratio [OR], 3.57; 95% confidence interval [CI], 1.05 to 12.5; P = 0.043) and receipt of a fluoroquinolone (OR, 9.09; 95% CI, 1.96 to 50; P = 0.005) were independently associated with better outcomes. Open debridement without removal of the implant had a success rate of 74.5%, and the factors associated with good prognosis were a CRP concentration at the time of diagnosis ≤15 mg/dl and treatment with a fluoroquinolone.

Preoperative platelet–lymphocyte ratio predicts recurrence of laryngeal squamous cell carcinoma

2020 ◽  
Vol 16 (6) ◽  
pp. 209-217
Author(s):  
Huijun Chen ◽  
Shenghua Song ◽  
Liqing Zhang ◽  
Weida Dong ◽  
Xi Chen ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Regression Model ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Laryngeal Squamous Cell Carcinoma ◽  
Cox Regression ◽  
Cox Regression Model ◽  
Lymphocyte Ratio ◽  
Platelet Lymphocyte Ratio ◽  
Kaplan Meier

Aim: To evaluate the impact of preoperative platelet–lymphocyte ratio (PLR), neutrophil–lymphocyte ratio (NLR), derived NLR (dNLR) and lymphocyte–monocyte ratio (LMR) on the prognosis of laryngeal squamous cell carcinoma. Materials & methods: Overall survival and recurrence-free survival (RFS) were analyzed using Kaplan–Meier estimates. Multivariable Cox regression model was used to evaluate the independent prognostic significance of variables. Results: High PLR (>103.96), NLR (>1.96) and dNLR (>1.70) predicted lower RFS according to Kaplan–Meier method. In COX regression model, patients with high PLR had poor RFS estimates compared with those with lower PLR (p < 0.001). Conclusion: Preoperative PLR was a more valuable prognostic factor than NLR, dNLR and LMR for the recurrence of laryngeal squamous cell carcinoma.

scholarly journals Atherosclerosis as a risk factor in the prognosis of the survival of patients with COPD

2021 ◽  
Vol 10 (Supplement_1) ◽  
Author(s):  
S Kotlyarov ◽  
A Kotlyarova
Keyword(s):  
Cardiovascular Diseases ◽  
Regression Model ◽  
Poor Prognosis ◽  
Roc Analysis ◽  
Cox Regression ◽  
Term Survival ◽  
Cox Regression Model ◽  
Kaplan Meier ◽  
History Of

Abstract Funding Acknowledgements Type of funding sources: None. Main funding source(s): no OnBehalf no Atherosclerosis is one of the key medical problems, as it contributes greatly to the structure of morbidity and mortality. Atherosclerosis rarely occurs in isolation, and is often combined with other diseases, including chronic obstructive pulmonary disease (COPD). The study of the significance of atherosclerosis and other key risk factors in the prognosis of COPD was carried out.  Materials and methods a study of the nature of the course of COPD for 15 years was carried out at three time control points (2005, 2008 and 2020). The presence of diseases associated with atherosclerosis in history, the severity of dyspnea according to the modified MRC scale and body mass index were taken into account. To assess the significance of the factors, a long-term survival analysis was performed using the Kaplan-Meier method. The statistical significance of the differences between the curves was assessed using the Log-rank test and the Breslow (Generalized Wilcoxon) and Tarone-Ware tests. To assess the influence of various factors and their combinations on long-term survival, a multivariate analysis was carried out using the Cox regression model (proportional hazards model).  Results and discussion The study included 170 men, with an average age of 60.09 ± 1.31 years. All patients smoked, the pack-years index was 43.78 ± 1.02. Of the 170 patients included in the study, 119 died by the third time point, which was 70%. The life expectancy of deceased patients averaged 70.48 ± 0.63 years. The main causes of death in patients with COPD are cardiovascular diseases caused by atherosclerosis, cancer, and respiratory failure. The most common cause of death in patients with COPD (68%) is diseases of the circulatory system associated with atherosclerosis. It was found that the presence of atherosclerosis in the anamnesis decreases the survival rate over a 15-year period. The graphs of the Kaplan-Meier survival curve depending on the presence of concomitant cardiovascular diseases in the anamnesis confirm the significance of the differences (p = 0.0194). It was also shown that an increase in the severity of dyspnea is associated with an increased risk of adverse outcomes (p &lt;0.001; ROC analysis, AUC = 0.737 ± 0.038). The analysis of survival using the construction of Kaplan-Meier curves showed that BMI &lt;21 is associated with a poor prognosis (p &lt;0.001; ROC analysis, AUC = 0.827 ± 0.043). The results of the Cox regression model showed that a history of atherosclerosis is a significant predictor of a poor prognosis in patients with COPD in a 15-year follow-up. It was shown that a history of atherosclerosis increases the risk of death in patients with COPD by 1.734 times.  Thus, concomitant cardiovascular diseases of atherosclerotic genesis, severe dyspnea and low body weight are a significant factor in the poor prognosis of COPD and should be taken into account when monitoring patients.

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