What is the clinical evidence from this study?

Study design: Review. Population: Chronic Obstructive Pulmonary Disease (COPD). Intervention: Cardiopulmonary risk management.

What does this research mean for the field?

COPD exacerbations significantly increase the risk of cardiovascular events, including acute coronary syndrome and heart failure, within the first 30 days post-exacerbation, necessitating integrated cardiopulmonary risk management. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This review aims to explore cardiopulmonary risk management strategies in COPD patients, particularly post-exacerbation.

April 19, 2026Open Access

Beyond the Lungs: A Narrative Review of Cardiopulmonary Risk Reduction and Management Perspectives in Thai COPD Patients

Key Result

COPD exacerbations significantly increase the risk of cardiovascular events within the first 30 days, including acute coronary syndrome (HR 3.74) and heart failure (HR 6.81).

Key Points

This review aims to explore cardiopulmonary risk management strategies in COPD patients, particularly post-exacerbation.
Evaluation of clinical studies and guideline recommendations
Assessment of Thailand-specific data
Outline of cardiopulmonary linkage in COPD
Proposed management strategies for post-exacerbation care
Identified increased cardiovascular events post-COPD exacerbation
Recommended optimized therapeutic strategies to reduce exacerbations
Emphasized integrated cardiopulmonary care for COPD patients with cardiovascular diseases
Highlighted the need for multidisciplinary education and collaboration in care

Structured PICO

Population

COPD patients, particularly those post-exacerbation or with established/suspected cardiovascular diseases, with a focus on the Thai population.

Intervention

Integrated cardiopulmonary risk management, including optimized pharmacological (e.g., triple inhaled therapy) and non-pharmacological therapies, and cardiovascular risk assessment.

Integrated cardiopulmonary risk management is essential for COPD patients, especially post-exacerbation, to mitigate the heightened risk of cardiovascular events and mortality.

Limitations

Direct effects of triple therapy in COPD patients with underlying HFpEF and ischemic heart diseases in preventing cardiovascular worsening and death remain unknown.
Cardiovascular benefits of triple therapy are based on assumption due to the limited availability of randomized controlled studies.
Synergistic effects between triple therapy and specific cardiovascular treatments remain inconclusive.

Abstract

Abstract: Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death worldwide and results in chronic lung damage and airway obstruction, significantly impacting individual health. Apart from increased all-cause mortality, COPD exacerbations are associated with higher rates of cardiovascular (CV) events—driven by shared risk factors and pathophysiological mechanisms—with peaks in the first 30 days of post-exacerbation. Therefore, cardiopulmonary risk management is essential during this vulnerable period. This narrative review was developed through an evaluation of clinical studies, guideline recommendations and Thailand-specific data to outline cardiopulmonary linkage in COPD and propose post-COPD exacerbation management. Patient management strategies include optimized pharmacological and non-pharmacological therapies, integrated cardiopulmonary care and CV risk assessment to reduce exacerbations, mortality and CV-related events, particularly in COPD patients with established or suspected CV diseases. Furthermore, implementation of these concepts should emphasize strengthening multidisciplinary awareness among pulmonary and cardiology through professional education, continuing-development activities and integration of collaborative care into national guidelines. Keywords: cardiopulmonary risk, cardiovascular risk, COPD management, COPD exacerbation, discharge planning

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