ABSTRACT
INTRODUCCIÓN: La enfermedad cardiovascular tiene un impacto negativo en el pronóstico vital de los pacientes con enfermedad pulmonar obstructiva crónica (EPOC), siendo la dislipidemia (DLP) y la hipertensión arterial (HTA) los factores de riesgo más prevalentes. El objetivo del estudio fue: 1) evaluar la relación existente entre el diagnóstico de DLP y la presencia de enfermedad cardiovascular en pacientes con EPOC, y compararlo con otros factores conocidos de riesgo cardiovascular; y 2) determinar la relación entre las diferentes comorbilidades cardiovasculares y los grupos de gravedad según la clasificación GOLD 2017. MÉTODOS: Estudio observacional transversal de 454 pacientes con EPOC en seguimiento ambulatorio. Se calculó la prevalencia de cada una de las comorbilidades cardiovasculares y el riesgo de que cada uno de los factores de riesgo cardiovascular se presentase conjuntamente con una enfermedad vascular (RRij). RESULTADOS: El 66,7% de los pacientes eran dislipidémicos. La DLP mostró una mayor relación con la presencia de accidentes cerebrovasculares (ACV) (RRij 1.36; p = 0,0054), enfermedad renal crónica (ERC) (RRij 1.34; p = 0,00023) y arteriopatía periférica (AP) (RRij 1.38; p = 0,00015); la HTA se relacionó mayormente con ACV (RRij 1,41; p = 0,0014) y ERC (RRij 1,42; p < 0,0001); la DMT2 con AP (RRij 1,90; p = 0,0001), insuficiencia cardiaca (IC) (RRij 1,74; p = 0,0002) y ERC (RRij 1,76; p < 0,0001); la obesidad con IC (RRij 1,60; p = 0,0009) y ERC (RRij 1.54; p = 0,0001). CONCLUSIÓN: La DLP se relacionó con la presencia de ACV, ERC y AP. La HTA y DMT2 se relacionaban mayoritariamente con IC y ACV
INTRODUCTION: Cardiovascular disease has a negative impact on the vital prognosis of patients with chronic obstructive pulmonary disease (COPD), where dyslipidaemia (DLP) and arterial hypertension (AHT) are considered the most prevalent risk factors. The objective of this study was 1) to assess the relationship between diagnosed DLP and cardiovascular disease in COPD patients and compare it with other known cardiovascular risk factors and 2) to determine the relationship between the different cardiovascular comorbidities and the severity groups according to the GOLD 2017 classification. METHODS: A cross-sectional, observational study was performed in 454 outpatients with COPD during their follow up. We calculated the prevalence of each of the cardiovascular comorbidities and the probability of each of the cardiovascular risk factors to occur jointly with a vascular disease (RRij). RESULTS: A total of 66.7% of the patients had DLP, whereby DLP was related to cerebrovascular accidents (CVA) (RRij 1.36, P=.0054), chronic kidney disease (CKD) (RRij 1.34, P=.00023), and peripheral arterial disease (PAD) (RRij 1.38, P=.00015). AHT was mostly related to CVA (RRij 1.41, P=.0014) and CKD (RRij 1.42, P<.0001). Type 2 diabetes mellitus (T2DM) correlated with PAD (RRij 1.90, P=.0001), heart failure (HF) (RRij 1,74, P=.0002), and CKD (RRij 1.76, P<.0001), and obesity was associated with HF (RRij 1.60, P=.0009) and CKD (RRij 1.54, P=.0001). CONCLUSION: DLP was related to CVA, CKD, and PAD. AHT and T2DM are the conditions that mostly relate to HF and CVA
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Pulmonary Disease, Chronic Obstructive/complications , Dyslipidemias/complications , Cardiovascular Diseases/complications , Risk Factors , Cross-Sectional Studies , Comorbidity , SpainABSTRACT
INTRODUCTION: Cardiovascular disease has a negative impact on the vital prognosis of patients with chronic obstructive pulmonary disease (COPD), where dyslipidaemia (DLP) and arterial hypertension (AHT) are considered the most prevalent risk factors. The objective of this study was 1) to assess the relationship between diagnosed DLP and cardiovascular disease in COPD patients and compare it with other known cardiovascular risk factors and 2) to determine the relationship between the different cardiovascular comorbidities and the severity groups according to the GOLD 2017 classification. METHODS: A cross-sectional, observational study was performed in 454 outpatients with COPD during their follow up. We calculated the prevalence of each of the cardiovascular comorbidities and the probability of each of the cardiovascular risk factors to occur jointly with a vascular disease (RRij). RESULTS: A total of 66.7% of the patients had DLP, whereby DLP was related to cerebrovascular accidents (CVA) (RRij 1.36, P=.0054), chronic kidney disease (CKD) (RRij 1.34, P=.00023), and peripheral arterial disease (PAD) (RRij 1.38, P=.00015). AHT was mostly related to CVA (RRij 1.41, P=.0014) and CKD (RRij 1.42, P<.0001). Type 2 diabetes mellitus (T2DM) correlated with PAD (RRij 1.90, P=.0001), heart failure (HF) (RRij 1,74, P=.0002), and CKD (RRij 1.76, P<.0001), and obesity was associated with HF (RRij 1.60, P=.0009) and CKD (RRij 1.54, P=.0001). CONCLUSION: DLP was related to CVA, CKD, and PAD. AHT and T2DM are the conditions that mostly relate to HF and CVA.
Subject(s)
Cardiovascular Diseases/complications , Pneumococcal Infections/prevention & control , Pneumococcal Vaccines/therapeutic use , Pulmonary Disease, Chronic Obstructive/complications , Aged , Aged, 80 and over , Disease Progression , Female , Forced Expiratory Volume , Hospitalization/statistics & numerical data , Humans , Logistic Models , Male , Middle Aged , Multivariate Analysis , Prospective Studies , Pulmonary Disease, Chronic Obstructive/physiopathology , Vaccination , Vaccines, ConjugateABSTRACT
OBJECTIVE: One of the major microorganisms described as the cause of exacerbations of chronic obstructive pulmonary disease (COPD) is Streptococcus pneumoniae. The aim of this study is to evaluate the impact of 13-valent pneumococcal conjugate polysaccharide vaccine (PCV13) on COPD patients with regard to the development of exacerbations and the possible differential effect according to the patient's phenotype. METHODS: Prospective observational study of patients with COPD and FEV1 ≤ 65% and 18-month follow-up. Main variables: vaccination status with PCV13, phenotype "exacerbator" or "non-exacerbator", number of exacerbations, hospitalization and deaths. A descriptive statistical analysis was performed according to the nature of the variable and an inferential analysis with CI95%, bivariate contrasts, and multivariate analysis. Significance level 5%. The statistical packages EPIDAT 3.0 and SPSS version 21.0 were used. RESULTS: 121 patients were included. Twenty-four percent were labeled as phenotype exacerbator. 36% were vaccinated with PCV13. During follow-up, 68% of patients had at least one exacerbation and 27% required hospitalization. We observed similarity (p> 0.05) in the number of exacerbations and deaths; however, the percentage of hospitalization in the vaccinated was 18%, compared to 32% in the non-vaccinated group. In the multivariate adjustment (controlling for the phenotype), an adjusted OR of 2.77 risk of hospitalization was observed in the non-vaccinated group (p = 0.044). CONCLUSIONS: Non-vaccination with PCV13 almost triples the risk of hospitalization in patients with COPD.
