Thirty percent of patients with chronic obstructive pulmonary disease (COPD) die of
cardiovascular disease, and it is hypothesized that the systemic inflammatory response
seen in acute exacerbations could be an important contributing risk factor. This observational
case series from England looked at the risk of myocardial infarction (MI) and stroke
after COPD exacerbations. The Health Improvement Network database contains the records
of primary care patients in England and Wales. There were 25,857 patients with COPD
in the database at the start of the observation period. Over 2 years, 524 MIs in 426
patients and 633 ischemic strokes in 482 patients were identified. The incidence rates
of MI and stroke were 1.1 and 1.4 per 100 patient-years, respectively. There was a
2.27-fold (95% confidence interval [CI] 1.1–4.7) increased risk of MI 1 to 5 days
after exacerbation. Beyond this time period, there was no statistically significant
increase in the risk of developing an MI. A 1.26-fold (95% CI 1.0–1.6) increased risk
of stroke 1 to 49 days after exacerbation was also observed. The authors concluded
that exacerbations of COPD increase the risk of MI and stroke.
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© 2010 Published by Elsevier Inc.
