ABSTRACT NUMBER: ESOC2026A2401 OPTIMISING COPD MANAGEMENT TO REDUCE STROKE RISK: REAL-WORLD EVIDENCE SUPPORTING THE USE OF SINGLE INHALED TRIPLE THERAPY FOR SECONDARY PREVENTION

Abstract Background and aims Chronic obstructive pulmonary disease (COPD) is increasingly recognised as an independent risk factor for cardiovascular and cerebrovascular disease. Acute COPD exacerbations are linked to increases in systemic inflammation, hypoxaemia, and pro-thrombotic states, which increase the risk of ischaemic stroke, transient ischaemic attack (TIA), and myocardial infarction up to a 70% in the first three months post-exacerbation. Optimisation of inhaled therapy, including the use of single-inhaler triple therapy (SITT), has been shown to reduce the risk of severe cardiopulmonary events in patients with COPD. Methods We conducted a retrospective observational analysis of 377 patients with COPD managed in primary care. Patients with comorbid stroke or TIA were identified, and demographic characteristics, exacerbation frequency, symptom burden, and inhaler regimens were assessed. Results Among 377 COPD patients, 48 (12.7%) had comorbid stroke or TIA (22 males, 26 females; mean age 75.6 years, SD 7.75); 13 experienced ≥2 exacerbations and 11 had one exacerbation in the preceding year. No patients with high exacerbation burden were receiving dual inhaler therapy. Thirty-one patients were treated with SITT, including 13 with both high symptom burden and frequent exacerbations. Conclusions COPD exacerbations are associated with increased risk of stroke. In this real-world cohort, comorbid stroke/TIA was common and frequently accompanied by exacerbation-prone disease. The high uptake of SITT among symptomatic, high-risk patients highlights its potential to reduce cardiopulmonary events. These findings support integrated respiratory and stroke prevention strategies, in which optimisation of inhaled therapy with SITT may represent a modifiable approach to reducing recurrent stroke risk in comorbid patients. Conflict of interest MD- Amarin/Recordati, Chiesi, Novartis, AstraZenica, Agilio