COPD and Cardiovascular Diseases: Biomarker-Guided Stratification and Therapeutic Perspectives

Chronic obstructive pulmonary disease (COPD) is a progressive and preventable respiratory disorder associated with a significantly increased risk of cardiovascular disease (CVD), including ischemic heart disease, heart failure, pulmonary hypertension, and arrhythmias. The association is bidirectional, with CVD adversely affecting COPD prognosis and vice versa. Beyond shared risk factors such as smoking, aging, and socioeconomic status, COPD itself, through mechanisms including systemic inflammation, oxidative stress, hypoxia, and hyperinflation, contributes independently to cardiovascular morbidity and mortality. Recent research has focused on identifying circulating biomarkers that can aid in early detection, risk stratification, and treatment optimization for patients at risk of both conditions. This review summarizes current evidence on the pathophysiological mechanisms linking COPD and CVD, highlights emerging biomarkers with potential prognostic utility for major adverse cardiovascular events (MACE) and all-cause mortality, and it discusses clinical and research implications for biomarker-guided, personalized treatment strategies.