Cardiovascular events in patients with bronchiectasis: Data from the European Bronchiectasis Registry (EMBARC)

<bold>Introduction:</bold> Bronchiectasis is a chronic inflammatory disorder, which is to promote cardiovascular events. Whether increased severity of bronchiectasis and resulting inflammation is associated with increased cardiovascular risk is unknown. <bold>Methods:</bold> The EMBARC registry is a multicentre, prospective, observational cohort study across 27 European countries and Israel. Clinical data were collected from adult patients (aged ≥18 years) at baseline and annual follow-up visits using electronic case report form. Time to first myocardial infarction (MI) was modelled using interval censored Cox proportional hazards regression. <bold>Results:</bold> Between 2015 and 2023, 18486 individuals were enrolled into the EMBARC registry. 8997 individuals with at least 1 year follow-up and without prior MI were identified at baseline and included in this analysis. The median age was 68 years (IQR 58-74), 5603 participants were female (62.3%) and 3394 participants were male (37.7%). The most common cause of bronchiectasis in the 8997 individuals was idiopathic (3368 cases, 37.4%), followed by post-infective (2003 cases, 22.3%). Overall, 79 new MI were found on follow up. After adjusting for multiple confounders, we observed that frequent exacerbations of bronchiectasis (≥3) were significantly associated with MI, with an unadjusted Hazard Ratio (HR) of 2.76 (95% CI 1.14-6.69, p=0.02) and an adjusted HR of 2.75 (95% CI 1.27-5.74, p=0.009). There are no significant differences with MI between gender, with a HR of 1.19 (95% CI 0.69-2.05, p=0.53) for female participants. <bold>Conclusion:</bold> Frequent exacerbations may increase the risk of cardiovascular events in people with bronchiectasis.

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Published
2024-09-14
DOI
https://doi.org/10.1183/13993003.congress-2024.oa2786
Primary Topic
Cystic Fibrosis Research Advances
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article
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article

Cardiovascular events in patients with bronchiectasis: Data from the European Bronchiectasis Registry (EMBARC)

Adam T. Hill, Francesco Blasi, Michael R. Loebinger, Josje Altenburg et al.
Cystic Fibrosis Research Advances
article

Cardiovascular events in patients with bronchiectasis: Data from the European Bronchiectasis Registry (EMBARC)

Adam T. Hill, Francesco Blasi, Michael R. Loebinger, Josje Altenburg, Michal Shteinberg, Robert C. Wilson, Charles Haworth, J.S. Elborn, Felix C. Ringshausen, Eva Polverino, Katerina Dimakou, Jamie Stobo, Rosario Menéndez, Pieter Goeminne, Benjamin JaaMing New, James Duncan Chalmers, Tobias Welte, Montserrat Vendrell, Anthony De Soyza, Pierre‐Régis Burgel, Stefano Aliberti, Megan Crichton, Marlène Murris, Wim Boersma, Antoni Torres
article en

Abstract

<bold>Introduction:</bold> Bronchiectasis is a chronic inflammatory disorder, which is to promote cardiovascular events. Whether increased severity of bronchiectasis and resulting inflammation is associated with increased cardiovascular risk is unknown. <bold>Methods:</bold> The EMBARC registry is a multicentre, prospective, observational cohort study across 27 European countries and Israel. Clinical data were collected from adult patients (aged ≥18 years) at baseline and annual follow-up visits using electronic case report form. Time to first myocardial infarction (MI) was modelled using interval censored Cox proportional hazards regression. <bold>Results:</bold> Between 2015 and 2023, 18486 individuals were enrolled into the EMBARC registry. 8997 individuals with at least 1 year follow-up and without prior MI were identified at baseline and included in this analysis. The median age was 68 years (IQR 58-74), 5603 participants were female (62.3%) and 3394 participants were male (37.7%). The most common cause of bronchiectasis in the 8997 individuals was idiopathic (3368 cases, 37.4%), followed by post-infective (2003 cases, 22.3%). Overall, 79 new MI were found on follow up. After adjusting for multiple confounders, we observed that frequent exacerbations of bronchiectasis (≥3) were significantly associated with MI, with an unadjusted Hazard Ratio (HR) of 2.76 (95% CI 1.14-6.69, p=0.02) and an adjusted HR of 2.75 (95% CI 1.27-5.74, p=0.009). There are no significant differences with MI between gender, with a HR of 1.19 (95% CI 0.69-2.05, p=0.53) for female participants. <bold>Conclusion:</bold> Frequent exacerbations may increase the risk of cardiovascular events in people with bronchiectasis.

Queen's University Belfast (GB), Humanitas University (IT), University of Milan (IT), Royal Papworth Hospital (GB), Ninewells Hospital (GB), Harefield Hospital (GB), Edinburgh Royal Infirmary (GB), Centre Hospitalier Universitaire de Toulouse (FR), Medizinische Hochschule Hannover (DE), Hôpital Cochin (FR), Northwest Hospital (US), Vall d'Hebron Institut de Recerca (ES), Institut d'Investigació Biomèdica de Girona (ES), Carmel Medical Center (IL), Hospital Clínic de Barcelona (ES), NIHR Newcastle Biomedical Research Centre (GB), Amsterdam University Medical Centers (NL), IRCCS Humanitas Research Hospital (IT), AZ Sint-Lucas (BE), Instituto de Investigación Sanitaria La Fe (ES), Sotiria General Hospital (GR), University of Amsterdam (NL)
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Cystic Fibrosis Research Advances
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