COPD patients had higher diagnostic testing rates (e.g., CCTA 6.6% vs 4.1%) and increased MI (4.8% vs 2.7%) and MACE (10.8% vs 6.9%) risks than non-COPD.
Is COPD associated with increased diagnostic testing for CAD and higher cardiovascular risk in patients aged 50-80 without prior CAD or stroke?
COPD is associated with a higher likelihood of undergoing diagnostic testing for CAD and an increased risk of major adverse cardiovascular events, highlighting the need for heightened cardiovascular vigilance in this population.
Absolute Event Rate: 0% vs 0%
Abstract Background and aims Diagnostic testing for coronary artery disease (CAD) and outcomes in patients with chronic obstructive pulmonary disease (COPD) have not previously been thoroughly investigated. Methods This nationwide register-based population study included all residents aged 50-80 years without prior CAD and stroke in 2008 in Denmark. The population was divided according to presence or absence of a hospital contact (either in- or out-patient) with COPD in the Danish National Patient Register. Patients were subdivided into three age-groups: 50-60, 60-70, and 70-80 years, and followed for a maximum of 10 years until diagnostic testing. Outcomes included coronary computed tomography angiography (CCTA), functional testing, and invasive coronary angiography (ICA), myocardial infarction (MI), revascularization, and major adverse cardiovascular events (MACE). Absolute risks (AR) were standardized according to age, sex, selected comorbidity, and pharmacotherapy distributions of all included subjects. Results This study included 31,576 patients with COPD and 1,438,148 patients without COPD. In all age groups, patients with COPD were more likely to undergo CCTA compared to patients without COPD (AR for ages 50-60 years: AR 6.6% with COPD vs.4.1% no COPD, p0.001, 60-70 years: AR 4.7%vs.3.9%, p0.001, 70-80 years: AR 2.8% vs.2.3%, p0.05), (figure 1). Similar differences were observed for ICA (AR for ages 50-60 years: AR 11.6% with COPD vs.6.0% without COPD, p0.001, 60-70 years: AR 14.0%vs.9.0%, p0.001, 70-80 years: AR 14.6% vs.11.3%, p0.001); MI (AR for ages 50-60 years: 4.8%vs.2.7%, p0.001, 60-70 years: 7.0%vs.3.9%, p0.001, 70-80 years: 10.7%vs.6.4%, p0.001); revascularization (AR for ages 50-60 years: 3.1%vs.2.6%, p0.05, 60-70 years: 4.7% vs.4.0%, p0.05, 70-80 years: 5.8% vs.5.4%, p0.05); and MACE (AR for ages 50-60 years: 10.8% vs.6.9%, p0.001, 60-70 years: 16.3% vs.11.4%, p0.001, 70-80 years: 24.8%vs.19.3%, p0.001) (figure 1). Among CCTA-examined patients, patients with COPD underwent functional testing to a lower extent than patients without COPD (AR for ages 50-60 years: 3.5% with COPD vs.4.1% with no COPD, p=0.06, 60-70 years: 3.2%vs.4.3%, p0.001, 70-80 years: 3.3%vs.4.5%, p0.05). Conversely, MI risks were higher in CCTA-examined patients with COPD compared to patients without COPD (AR for ages 50-60 years: 3.4% with COPDvs.2.9% without COPD, p=0.115, 60-70 years: 5.2%vs.3.5%, p0.001, 70-80 years: 7.8%vs.6.1%, p=0.037). Revascularization risks were similar(figure 2). Conclusion COPD versus non-COPD was associated with undergoing diagnostic testing for CAD. It included coronary computed tomography angiography(CCTA), functional testing and invasive coronary angiography. Moreover, COPD was associated with an increased rate of myocardial infarction, revascularization, and major adverse cardiovascular events. Following CCTA, patients with COPD were less likely to undergo functional testing compared to patients without COPD.Figure 1:Absolute risks. Figure 2:Absolute risks.
Lauridsen et al. (Sat,) reported a other. COPD patients had higher diagnostic testing rates (e.g., CCTA 6.6% vs 4.1%) and increased MI (4.8% vs 2.7%) and MACE (10.8% vs 6.9%) risks than non-COPD.