scholarly journals Major comorbidities lead to the risk of adverse cardiovascular events in chronic obstructive pulmonary disease patients using inhaled long-acting bronchodilators: a case-control study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yen-Fu Chen ◽  
Yi-Ching Cheng ◽  
Chien-Hong Chou ◽  
Chung-Yu Chen ◽  
Chong-Jen Yu
Keyword(s):  
Cardiovascular Events ◽  
Case Control Study ◽  
Case Control ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
History Of ◽  
Long Acting ◽  
Control Study ◽  
Related Mortality

Abstract Background While inhaled bronchodilators reduce symptoms and acute exacerbations of chronic obstructive pulmonary disease (COPD), their use is associated with increased cardiovascular events in some studies. This study investigates the risk of adverse events associated with the use of inhaled bronchodilators in COPD patients with multimorbidity. Methods A case-control study was conducted between January 2015 and December 2017, and patients with spirometry-confirmed diagnosis of COPD (N = 1565) using inhaled long-acting bronchodilators were enrolled. Medical records were reviewed and clinical data, including age, gender, smoking status, major comorbidities, lung function stage, history of exacerbations, bronchodilator regimens, and treatment duration were analyzed. Major adverse cardiovascular events occurring during long-acting bronchodilator use were recorded. Results The most common comorbidities were cardiovascular disease (CVD) (53.6%) and chronic kidney disease (CKD) (25.8%). We observed that CVD (odds ratio [OR], 5.77), CKD (OR, 2.02) and history of frequent exacerbations (OR, 2.37) were independent risk factors for cardiovascular events, regardless of the type of bronchodilators use. Moreover, COPD patients with both CKD and CVD had higher risk (6.32-fold) of adverse cardiovascular effects than those with neither comorbidity. Eighty-seven of 1565 (5.56%) COPD patients died during this study period. Of them, 21.8% (19/87) were cardiovascular-related and 73.6% (64/87) patients were respiratory-related mortality. Among COPD patients using long-acting bronchodilators, CKD was the only risk factor to predict cardiovascular events and cardiovascular-related mortality (OR, 4.87; 95% confidence interval [CI], 1.75–13.55]. Conclusions COPD patients had higher risk of cardiovascular events were associated with their CVD and/or CKD comorbidities and history of frequent exacerbations, rather than associated with their use of inhaled bronchodilators.

scholarly journals Predictors of acute cardiovascular events following acute exacerbation period for patients with COPD: a nested case–control study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Wei-ping Hu ◽  
Tsokyi Lhamo ◽  
Feng-ying Zhang ◽  
Jing-qing Hang ◽  
Yi-hui Zuo ◽  
...  
Keyword(s):  
Acute Exacerbation ◽  
Cardiovascular Events ◽  
Case Control Study ◽  
Case Control ◽  
Left Ventricular ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Coronary Syndrome ◽  
Nested Case Control ◽  
Control Study

Abstract Background It has been noted that there is an increase in the incidence of acute cardiovascular events (CVEs) in patients with chronic obstructive pulmonary disease (COPD) during an acute exacerbation (AE), thereby causing increased inpatient mortality. Thus, we have tried to identify predictors of acute CVEs in patients with AECOPD via a nested case–control study. Methods A total of 496 cases hospitalized for AECOPD were included in this study, and followed-up for up to 6 months after discharge. Acute CVEs in the AE period were defined as a new or worsening acute coronary syndrome (ACS), arrhythmia, or left ventricular disfunction (LVD). Predictors of CVEs were selected from several variables, including baseline characteristics and treatments in the stable period as well as symptoms, laboratory tests, complications and treatments in the AE period. Results Thirty cases (6.05%) had acute CVEs, namely 2 had ACS, 13 had LVD and 19 experienced some form of arrhythmia. Four deaths were observed in the CVE group, with significantly increased death risk compared with the non-CVE group (P = 0.001, OR = 5.81). Moreover, patients who had CVEs were more prone to have re-exacerbation within 3 months. Multivariate analysis showed that previous LVD history (P = 0.004, OR = 5.06), 20% increase in heart rate (HR) (P = 0.003, OR = 10.19), electrolyte disturbance (P = 0.01, OR = 4.24) and diuretics (P = 0.002, OR = 6.37) were independent predictors of CVEs. In addition, usage of theophylline, fluoroquinolone and inhaled beta agonists in the AE period were not statistically associated with acute CVEs. Conclusions Our preliminary study indicates that patients hospitalized for AECOPD with previous LVD history or increased HR need close observation and diuretics should be cautiously used with regular electrolyte monitoring. These findings need to be confirmed in a large cohort.

scholarly journals Evaluation of tuberculosis associated chronic pulmonary disease at community health care: a case control study

2021 ◽  
Author(s):  
Chandan Sharma ◽  
Ashima Badyal
Keyword(s):  
Pulmonary Disease ◽  
Case Control Study ◽  
Previous History ◽  
Policy Decision ◽  
Case Control ◽  
Chronic Obstructive ◽  
Duration Of Symptoms ◽  
Copd Patients ◽  
History Of ◽  
Control Study

Background: Chronic obstructive pulmonary disease (COPD) is known to occur in patients with previous history of pulmonary TB. It is still not very well known if there is any difference of clinical presentation between smoking related COPD or/and TB associated COPD.  Methods: The present case control study was conducted at CHC Katra, Department of Medicine, over a period of 6 months from August 2018 to February 2018, on 100 patients; 50 suffering from COPD and 50 healthy individuals. Detailed clinical history for duration of symptoms, previous hospitalizations, and exposure to smoking along with the history of TB and ATT courses was recorded.Results: History of TB was found in 17 patients among cases and 7 patients among controls. In TB associated COPD, the pack years of smoking in case of smokers was 22.4±19.2. 44% (15/34) having exposure to smoking had history of TB. Mean age of patients exposed to smoking was (53.3±7.4) and that of non-smokers (60.1±8.2). A positive correlation with age, BMI, and duration of symptoms was found. Our results showed that almost one-third of COPD patients (34%) had history of TB. TB-associated COPD patients had similar symptoms in our study except for high frequency of hemoptysis.Conclusions: A detailed population survey is needed on COPD patients with history of TB. A larger group study among never-smokers is also needed. Finally, it is concluded that the case burden of TB associated COPD is real, huge and an urgent policy decision in this regard is mandated.

scholarly journals Predictors of acute cardiovascular events following acute exacerbation period for patients with COPD: a nested case-control study

2020 ◽  
Author(s):  
Weiping Hu ◽  
Tsokyi Lhamo ◽  
Feng-ying Zhang ◽  
Jing-qing Hang ◽  
Yi-hui Zuo ◽  
...  
Keyword(s):  
Acute Exacerbation ◽  
Cardiovascular Events ◽  
Case Control Study ◽  
Case Control ◽  
Left Ventricular ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Coronary Syndrome ◽  
Nested Case Control ◽  
Control Study

Abstract BackgroundFor patients with chronic obstructive pulmonary disease (COPD), the incidence of acute cardiovascular events (CVEs) increases during acute exacerbation (AE) period, causing increased inpatient mortality. Thus, we try to identify predictors of acute CVEs in patients with AECOPD via a nested case-control study.MethodsA total of 496 cases hospitalized for AECOPD were included into analysis, and followed-up for 6 months after discharge. Acute CVEs in the AE period were defined as the new or worsening acute coronary syndrome (ACS), arrhythmia, left ventricular disfunction (LVD). Predictors were selected from several variables, including baseline characteristics and treatments in the stable period as well as symptoms, laboratory tests, complications and treatments in the AE period.ResultsThirty cases (6.05%) had acute CVEs, including 2 with ACS, 13 with LVD and 19 with arrhythmia. Four deaths were observed in the CVE group, with significantly increased death risk compared with the non-CVE group (P=0.001, OR=5.81). Moreover, patients who have had CVEs were vulnerable to have re-exacerbation within 3 months. Multivariate analysis showed that previous LVD history (P=0.004, OR=5.06), 20% increase in heart rate (HR) (P=0.003, OR= 10.19), electrolyte disturbance (P=0.01, OR= 4.24) and diuretics (P=0.002, OR = 6.37) were independent predictors. In addition, usage of theophylline, fluoroquinolone and inhaled beta agonists in the AE period were not statistically associated with acute CVEs.ConclusionsOur study preliminarily indicated that patients hospitalized for AECOPD with previous LVD history or increased HR need close observation and diuretics should be cautiously used with electrolyte monitoring. These findings needs to be confirmed in a large cohort.

scholarly journals Assessment of arterial stiffness in stable patients of chronic obstructive pulmonary disease: a prospective case control study

2018 ◽  
Vol 7 (11) ◽  
pp. 2078
Author(s):  
Sandeep Kumar ◽  
D. D. Gupta ◽  
Malay Sarkar ◽  
Ramesh .
Keyword(s):  
Cardiovascular Disease ◽  
Arterial Stiffness ◽  
Case Control Study ◽  
Case Control ◽  
Chronic Obstructive ◽  
Cardiovascular Risks ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Control Study ◽  
Prospective Case Control Study

Background: Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality worldwide and represents a substantial socioeconomic burden. Co-morbidities are more in COPD patients. Cardiovascular disease is one of the co-morbid conditions in COPD. Arterial stiffness has a strong predictive value for cardiovascular events, which can be assessed non-invasively. Various predictors of arterial stiffness between stable COPD patients and healthy volunteers were measured and compared.Methods: COPD patients attending pulmonary medicine outpatient services were screened for enrolment. It was a prospective case control study with enrolment of fifty COPD stable cases and fifty healthy control, who were matched for their age and sex. All eligible participants were subjected to focused history and physical examination as per structured questionnaire, followed by spirometric examination, periscope test, arterial blood gas analysis and six- minute walk test (6MWT).Results: Increased arterial stiffness was observed in COPD patients over a wide range of severity of airway obstruction. Distance walked in 6MWT and spirometric values were significantly lower in COPD group as compared to healthy group.Conclusions: It was concluded that vascular changes, which are predictive of cardiovascular disease remain as cardiovascular risks in mild or early lung disease. A strong relationship between COPD, systemic inflammation, arterial stiffness and cardiovascular disease had been found which needs to be explored further. It was finally concluded that targeted therapeutic approach has broad aspect in reducing cardiovascular risks and has potential for improved prognosis in COPD.

scholarly journals Predictors of acute cardiovascular events following acute exacerbation period for patients with COPD: a nested case-control study

2020 ◽  
Author(s):  
Weiping Hu ◽  
Tsokyi Lhamo ◽  
Feng-ying Zhang ◽  
Jing-qing Hang ◽  
Yi-hui Zuo ◽  
...  
Keyword(s):  
Acute Exacerbation ◽  
Cardiovascular Events ◽  
Case Control Study ◽  
Case Control ◽  
Left Ventricular ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Coronary Syndrome ◽  
Nested Case Control ◽  
Control Study

Abstract Background It has been noted that there is an increase in the incidence of acute cardiovascular events (CVEs) in patients with chronic obstructive pulmonary disease (COPD) during an acute exacerbation (AE) , thereby causing increased inpatient mortality. Thus, we have tried to identify predictors of acute CVEs in patients with AECOPD via a nested case-control study.Methods A total of 496 cases hospitalized for AECOPD were included in this study, and followed-up for up to 6 months after discharge. Acute CVEs in the AE period were defined as a new or worsening acute coronary syndrome (ACS), arrhythmia, left ventricular disfunction (LVD). Predictors of CVEs were selected from several variables, including baseline characteristics and treatments in the stable period as well as symptoms, laboratory tests, complications and treatments in the AE period. Results Thirty cases (6.05%) had acute CVEs, namely 2 had ACS, 13 had LVD and 19 experienced some form of arrhythmia. Four deaths were observed in the CVE group, with significantly increased death risk compared with the non-CVE group (P=0.001, OR=5.81). Moreover, patients who had CVEs were more prone to have re-exacerbation within 3 months. Multivariate analysis showed that previous LVD history (P=0.004, OR=5.06), 20% increase in heart rate (HR) (P=0.003, OR= 10.19), electrolyte disturbance (P=0.01, OR= 4.24) and diuretics (P=0.002, OR = 6.37) were independent predictors of CVEs. In addition, usage of theophylline, fluoroquinolone and inhaled beta agonists in the AE period were not statistically associated with acute CVEs. Conclusions Our preliminary study indicates that patients hospitalized for AECOPD with previous LVD history or increased HR need close observation and diuretics should be cautiously used with regular electrolyte monitoring. These findings need to be confirmed in a large cohort.

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