Association of Cardiovascular Disease and Its Subtypes with Prognosis in Hospitalized Patients with AECOPD: A Retrospective Cohort Study

Objective: Cardiovascular diseases (CVDs) are common in patients hospitalized with acute exacerbation of chronic obstructive pulmonary disease (AECOPD), yet the prognostic impact of specific CVD subtypes remains unclear. Methods: This retrospective study included 977 patients with AECOPD admitted to Hebei Yanda Hospital. Baseline characteristics were compared between patients with and without CVDs. After adjustment for relevant potential confounders identified in the univariable analysis, multivariable logistic regression assessed associations with adverse in-hospital outcomes, and Cox proportional hazards models evaluated one-year readmission. Additional analyses were performed for CVD subtypes-heart failure (HF), ischemic heart disease (IHD), atrial fibrillation (AF), and stroke-and across clinical subgroups. Results: Among the included patients, 341 (34.9%) had CVDs. These patients were older and had higher heart rate, blood pressure, inflammatory markers, and lower hemoglobin and lymphocyte ( P < 0.05). After multivariable adjustment, CVDs were associated with adverse in-hospital outcomes (adjusted OR 1.43, 95% CI 1.05– 1.94, P = 0.023) and a higher risk of 1-year readmission (adjusted HR 1.57, 95% CI 1.21– 2.05, P = 0.001). Subtype analyses showed that HF and IHD were significantly associated with adverse in-hospital outcomes, while HF and AF predicted higher 1-year readmission risk ( P < 0.05). Kaplan-Meier curves showed a higher readmission risk in patients with CVDs ( P < 0.001). These associations were generally consistent across subgroups, with a significant interaction observed only for HF in patients younger than 70 years. Conclusion: CVDs were common and were associated with worse in-hospital outcomes and higher 1-year readmission risk. CVD subtypes should be considered in risk stratification and clinical management. Further studies with more detailed treatment and follow-up data are needed to better define the role of CVD-specific management in improving outcomes. Keywords: acute exacerbation of chronic obstructive pulmonary disease, cardiovascular diseases, prognosis