Abstracts| Volume 39, ISSUE 5, P709-710, November 2010

Increased Risk of Myocardial Infarction and Stroke Following Exacerbation of COPD

Donaldson G, Hurst J, Smith C, Hubbard RB, Wedzicha JA. Chest 2010;137:1091–7.
      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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