MACE in COPD: addressing cardiopulmonary risk

Chronic obstructive pulmonary disease (COPD) and cardiovascular disease are both major global public health burdens, with a burden of 74·4 million and 393 million disability-adjusted life-years, respectively, in 2019. 1 Safiri S Carson-Chahhoud K Noori M et al. Burden of chronic obstructive pulmonary disease and its attributable risk factors in 204 countries and territories, 1990–2019: results from the Global Burden of Disease Study 2019. BMJ. 2022; 378: e069679 PubMed Google Scholar , 2 Vos T Lim SS Abbafati C et al. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020; 396: 1204-1222 Summary Full Text Full Text PDF PubMed Scopus (7666) Google Scholar Given shared exposures and risk factors (eg, smoking, socioeconomic deprivation, diabetes, hypertension, low levels of exercise, and dyslipidaemia), it is not surprising that many people living with COPD have cardiovascular disease. Patients with COPD are two to five times more likely to develop cardiovascular disease compared with the general population. 3 Curkendall SM Lanes S de Luise C et al. Chronic obstructive pulmonary disease severity and cardiovascular outcomes. Eur J Epidemiol. 2006; 21: 803-813 Crossref PubMed Scopus (96) Google Scholar When coexistent, cardiovascular disease is associated with adverse prognosis in COPD, and it is estimated that about one in five patients with COPD will have a cardiovascular cause of death. 4 Sin DD Anthonisen NR Soriano JB Agusti AG Mortality in COPD: role of comorbidities. Eur Respir J. 2006; 28: 1245-1257 Crossref PubMed Scopus (823) Google Scholar Unscheduled hospitalisation because of a cardiovascular event is not infrequent in patients with COPD. Notably, the magnitude of the association of cardiovascular hospitalisation with COPD, as well as the risk of admission to hospital with myocardial infarction, heart failure, and angina, is greater with increasing severity of COPD. 3 Curkendall SM Lanes S de Luise C et al. Chronic obstructive pulmonary disease severity and cardiovascular outcomes. Eur J Epidemiol. 2006; 21: 803-813 Crossref PubMed Scopus (96) Google Scholar