Major adverse cardiovascular events in a real-life COPD patient population

<bold>Background:</bold> Chronic obstructive pulmonary disease (COPD) is associated with a significantly higher risk of cardiovascular disease (CVD) and major adverse cardiovascular events (MACE). <bold>Objectives:</bold> The aim of this study was to measure the incidence of MACE and to identify its potential risk factors in a tertiary hospital COPD population. <bold>Methods:</bold> For this retrospective study, we collected COPD patients’ baseline characteristics and longitudinal data regarding spirometry, inhalation treatment, blood eosinophil count (BEC) and 4-point MACE (i.e. cardiovascular death, non-fatal stroke, non-fatal myocardial infarction and hospitalization for unstable angina and revascularization procedures). We performed logistic regression analysis to predict the odds ratio (OR) of independent variables for MACE. <bold>Results:</bold> 462 patients were eligible for inclusion, of whom 14% (n=66) developed MACE during the mean follow up period of 4.5 years. Patients were on average 69.7 (± 9.4) years old at baseline. Smoking status, pack years, BMI, untreated obstructive sleep apnea, FEV1 and inhalation corticosteroid treatment at baseline did not differ significantly between the patient groups with and without MACE. The presence of BEC >300cells/µL during follow up was more often found in patients with MACE (65% vs 46% in the control group; p=0.007); the proportion of males was higher in the MACE group (79% vs 61% in the control group; p=0.009). Logistic regression identified BEC >300cells/µL (OR 2.05; 95%CI 1.15-3.65; p=0.01) and male sex (OR 1.96; 95%CI 1.01-3.85; p=0.04) as predictors of MACE. <bold>Conclusion:</bold> COPD patients with BEC >300cells/µL and male patients may be at higher risk of MACE. These patients would likely benefit from early screening for CVD.