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CHA2DS2-VASc Scores Predict Major Adverse Cardiovascular Events in Patients with Chronic Obstructive Pulmonary Disease.

CHA2DS2-VASc Scores Predict Major Adverse Cardiovascular Events in Patients with Chronic Obstructive Pulmonary Disease.
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Ooi H, Chen LH, Ni YL, Shen HT, Lee YH, Chu YC, Fang KC, Chen IH, Hsu SL, Chen HC, Huang CH, Fan KS, Lai CL, Hang LW,


Ooi H, Chen LH, Ni YL, Shen HT, Lee YH, Chu YC, Fang KC, Chen IH, Hsu SL, Chen HC, Huang CH, Fan KS, Lai CL, Hang LW, (click to view)

Ooi H, Chen LH, Ni YL, Shen HT, Lee YH, Chu YC, Fang KC, Chen IH, Hsu SL, Chen HC, Huang CH, Fan KS, Lai CL, Hang LW,

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The clinical respiratory journal 2017 03 07() doi 10.1111/crj.12624
Abstract
INTRODUCTION
Patients with chronic obstructive pulmonary disease (COPD) frequently experience concurrent comorbidities; therefore, risk assessment for major adverse cardiovascular events (MACEs) is very important.

OBJECTIVES
We explored the association between COPD and risk of MACEs with three common clinical events: acute myocardial infarction (AMI), ischemic stroke (IS), and cardiovascular death (CVD).

METHODS
We evaluated the predictive value of the CHA2DS2-VASc score (congestive heart failure [C], hypertension [H), age [A], diabetes [D), stroke [S], and vascular disease [VASc]) for MACEs in COPD patients. In this observational study, we retrospectively reviewed the records of 29258 patients with COPD between 2005 and 2009 in relation to MACE risk by using the CHA2DS2-VASc score. We calculated the hazard ratios (HR) and 95% confidence intervals (CI) using a significance level of 0.05.

RESULTS
Patients with COPD had significantly (P < 0.001) increased risk of MACEs, and a high prevalence of CHA2DS2-VASc scores ≥ 6, predicting MACEs (16.1%), AMI (3.3%), IS (8.7%), and CVD (4.0%). A good discrimination was found for MACEs, IS events, and CVD events (AUC = 0.740, 0.739, and 0.778, respectively) but poorer discrimination for AMI events (AUC = 0.697). CONCLUSION
Early lifestyle modifications and antithrombotic therapy may be essential for COPD patients at a high risk of MACEs, i.e. those with CHA2DS2-VASc scores ≥ 6. This article is protected by copyright. All rights reserved.

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