Characteristics of COPD patients experiencing cardiovascular events during hospitalization for COPD exacerbation

Cardiovascular (CV) events occur frequently during COPD exacerbations (ECOPD). We aimed to identify risk factors related to the occurrence of CV events during hospitalization for ECOPD. Historical files of patients with ECOPD admitted in the respiratory medicine departments of two tertiary hospitals were used. Demographic, laboratory and functional characteristics upon admission were recorded. Electrocardiographic parameters were scored by two specialized cardiologists. The occurrence of CV events during hospital stay was also recorded. 209 patients [34.7% female, age 71(65, 78) years] were included. CV events occurred in 47(22.3%) patients [2% acute coronary syndrome, 25% arrythmia and 76.5% pulmonary oedema]. 86.9% of CV events occurred during the first day. On admission, patients who experienced CV events had lower pH 7.34(7.30, 7.49) vs 7.40(7.35, 7.43), p<0.001, higher WBC 11080(8990, 14530) vs 9935(7202, 12652), p=0.010, serum potassium 4.7(4.3, 5.1) vs 4.4(4.1, 4.8),p=0.008, LDH 264 (206, 361) vs 223 (185, 268), p=0.005, troponin 11.6(5.4, 28.5) vs 7.2(3.5, 13.4), p=0.005 and BNP 207(126, 435) vs 112 (25, 278), p=0.023, higher respiratory rate 18(16, 20) vs 16(15, 18) p=0.004 and higher dyspnea (mMRC) on stability 4.0 (3.2, 4/0) vs 3.0(3.0,4.0), p=0.003. Patients more prone to experience a CV event were those on LTOT 30% vs 14.2% p=0.020, those with a history of CV disease 26% vs 14.2%, p=0.047, those and those with increased cardiothoracic ratio on CXR 38% vs 17.7%, p=0.003. CV events occur frequently during hospitalization of ECOPD. The recognition of predictive factors for CV events might help physicians to develop therapeutic strategies for their prevention.