CCCardiol CroatCardiologia CroaticaCardiol. Croat.1848-543X1848-5448Croatian Cardiac SocietyCC 2024 19_3-4_114-510.15836/ccar2024.114Extended AbstractInterdisciplinary approach to cardiovascular diseaseA retrospective study on chronic obstructive pulmonary disease severity and cardiovascular comorbiditieshttps://orcid.org/0000-0002-8909-9216KovačevićAna1*https://orcid.org/0000-0002-7779-9805KovačevićStjepan1https://orcid.org/0009-0002-4123-0171DumančićIva1https://orcid.org/0009-0003-3553-3229FranićMaja1https://orcid.org/0009-0009-9454-9785MeterJosipa1https://orcid.org/0000-0002-7655-6078BukalNikolina1https://orcid.org/0000-0002-2650-4405LekoNinoslav1https://orcid.org/0000-0001-6568-3306MiškićBlaženka12https://orcid.org/0000-0001-6188-0708Cvitkušić LukendaKatica12General Hospital “Dr. Josip Benčević”, Slavonski Brod, CroatiaJosip Juraj Strossmayer University of Osijek, Faculty of Dental Medicine and Health Osijek, Osijek, CroatiaADDRESS FOR CORRESPONDENCE: Ana Kovačević, Opća bolnica “Dr. Josip Benčević“, Andrije Štampara 42, HR-35000 Slavonski Brod, Croatia. / Phone number: +385 98 976 0629 / E-mail: ana.bardak@gmail.com112023112023193-41141152110202327102023Croatian Cardiac Society2023Croatian Cardiac SocietyKEYWORDS: chronic obstructive pulmonary diseasecardiovascular diseasestherapy exacerbation
Introduction: Chronic obstructive pulmonary disease (COPD) is a global health issue characterized by progressive airflow limitation and respiratory symptoms (1, 2). Recent research have shown that patients with COPD often have a higher prevalence of cardiovascular diseases (CVD), including hypertension, coronary artery disease, and congestive heart failure (3, 4). This retrospective study aims to compare prevalence of CVD based on COPD severity.
Patients and Methods: Data were collected from patients with COPD attending Pulmonology Clinic between April 2023, and October 2023. We divided patients into Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages I or II (FEV1 >50%) and GOLD stages III or IV (FEV1 <50%). We compared groups regarding the frequency of cardiovascular comorbidities, gender, age, treatments, current smoking status, COPD exacerbations in the past year, and hospitalizations. Statistical analysis used IBM SPSS Statistics 26. Categorical variables were analysed with Fisher’s exact test, while numerical variables underwent Student’s t-test. All p-values were two-tailed, with significance set at p = 0.05.
Results: In this study of 109 COPD patients, those in GOLD stages I or II (n=56) had a mean age of 67.7±12.9 years, and those in GOLD stages III or IV (n=53) had a mean age of 70.6±6.9 years (p=0.2). In GOLD stage III or IV group, had more male patients, higher exacerbations rate, and increased long-term oxygen therapy usage compared to GOLD stage I or II (Table 1). Mean FEV1 in GOLD I or II patients was 65.1±11.1%, while in GOLD III or IV patients, 33.9±10.6% (p<0.001). Hospitalization rates were significantly lower for the former group (0.09±0.3 vs. 0.4±0.6, p=0.005). Figure 1 shows the frequency of CVD depending on GOLD stage, no statistical significance was found between the two. GOLD stage I or II patients significantly more often have LAMA and LABA+LAMA in their therapy, while GOLD stage III or IV patients have SABA+SAMA and IC+LABA+LAMA (Figure 2). Notably, the choice of cardiovascular therapy did not differ significantly between these groups (Figure 3).
Baseline characteristics of participants.
N (%)
GOLD stage I or II
GOLD stage III or IV
Total
P*
Gender
Male
29 (51.8)
40 (75.5)
69 (63.3)
0.02
Female
27 (48.2)
13 (24.5)
40 (36.7)
Cardiovascular disease
Yes
37 (66.1)
35 (66.0)
72 (66.1)
>0.9
No
19 (33.9)
18 (34.0)
37 (33.9)
Long-term oxygen therapy
Yes
1 (1.8)
10 (18.9)
11 (10.1)
0.003
No
55 (98.2)
43 (81.1)
98 (89.9)
Current smoking
Yes
27 (48.2)
17 (32.1)
44 (40.4)
0.1
No
29 (51.8)
36 (67.9)
65 (59.6)
Exacerbation of COPD over the one year-period
Yes
15 (26.8)
33 (62.3)
48 (44.0)
<0.001
No
41 (73.2)
20 (37.7)
61 (56.0)
COPD = Chronic obstructive pulmonary disease; GOLD = Global Initiative for Chronic Obstructive Lung Disease; * Fisher’s Exact Test
Comorbidities and cardiovascular diseases among patients depending on the severity of chronic obstructive pulmonary disease.
The difference in the choice of therapy depending on the GOLD stage (Fisher’s Exact Test). IC = inhaled corticosteroid; LAMA = long-acting muscarinic antagonist; LABA = long-acting β2 agonist; SAMA = short-acting muscarinic antagonist; SABA= short-acting β2 agonist; SS = SAMA+SABA; LL = LAMA+LABA; IL = IC+LABA; ILL = IC+LAMA+LABA.
The distribution of the use of cardiovascular therapy between Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage I or II and GOLD stage III or IV groups. BP = blood pressure medication; BB = beta-blockers; CLM = cholesterol-lowering medication, AT = anticoagulant therapy; ASA = aspirin; CG = cardiac glycosides; AA = aldosterone antagonists; D = diuretics.
Conclusion: Despite prior research, we could not confirm the COPD severity-CVD link. Further research is vital to emphasize the need for personalized care, considering the limitation of a small patient sample.
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