Oral corticosteroid and risk for major adverse cardiovascular events in outpatients with chronic obstructive pulmonary disease, a Danish registry-based cohort study.

<bold>Background:</bold> Exacerbations of chronic obstructive pulmonary disease (COPD) often require oral corticosteroids (OCS), which can improve lung function but may have adverse effects, including cardiovascular disease. Despite shared risk factors between COPD and cardiovascular disease, the effect of short-term OCS use on major adverse cardiovascular events (MACE) is unclear. This study aims to assess the risk of MACE with short-term OCS use in COPD patients. Methods: A nationwide cohort study using the Danish Register of COPD (DrCOPD) from 2010-2022. Exposure was defined as the first prescription of OCS and respiratory antibiotics after entry in DrCOPD. Exposed patients were matched with those prescribed only respiratory antibiotics based on clinical parameters. Primary outcomes were all MACE, measured within 20 days of exposure. Results: Among 108,275 patients in DrCOPD, 15,504 (7,752x2) patients were included. Short-term OCS use was not associated with an increased risk of MACE compared to respiratory antibiotics (Hazard Ratio (HR)=1.00, CI 0.72–1.40, p=1.00). The result was consistent in sensitivity analysis. Conclusion: The study found no increased risk of MACE within 20 days of short-term OCS use compared to respiratory antibiotics in COPD outpatients <fig><object-id>erj;66/suppl_69/PA4543/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>