Association of Cardiovascular Disease With Respiratory Disease |
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Authors: | Paul Carter Jakub Lagan Christien Fortune Deepak L. Bhatt Jørgen Vestbo Robert Niven Nazia Chaudhuri Erik B. Schelbert Rahul Potluri Christopher A. Miller |
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Affiliation: | 1. ACALM Study Unit in collaboration with Aston Medical School, Aston University, Birmingham, United Kingdom;2. Cambridge Cardiovascular Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom;3. Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom;4. Manchester University NHS Foundation Trust, Wythenshawe Hospital, Manchester, United Kingdom;5. Brigham and Women’s Hospital Heart & Vascular Center, Harvard Medical School, Boston, Massachusetts;6. Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom;7. Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania;8. UPMC Cardiovascular Magnetic Resonance Center, Heart and Vascular Institute, Pittsburgh, Pennsylvania;9. Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, Pennsylvania;10. Wellcome Centre for Cell-Matrix Research, Division of Cell-Matrix Biology & Regenerative Medicine, School of Biology, Faculty of Biology, Medicine & Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom |
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Abstract: | BackgroundThe relationship between respiratory diseases and individual cardiovascular diseases, and the impact of cardiovascular diseases on mortality in patients with respiratory disease, are unclear.ObjectivesThis study sought to determine the relationship between chronic obstructive pulmonary disease (COPD), asthma and interstitial lung disease (ILD), and individual cardiovascular diseases, and evaluate the impact of individual cardiovascular diseases on all-cause mortality in respiratory conditions.MethodsThe authors conducted a cohort study of all patients admitted to 7 National Health Service hospitals across the North West of England, between January 1, 2000, and March 31, 2013, with relevant respiratory diagnoses, with age-matched and sex-matched control groups.ResultsA total of 31,646 COPD, 60,424 asthma, and 1,662 ILD patients were included. Control groups comprised 158,230, 302,120, and 8,310 patients, respectively (total follow-up 2,968,182 patient-years). COPD was independently associated with ischemic heart disease (IHD), heart failure (HF), atrial fibrillation, and peripheral vascular disease, all of which were associated with all-cause mortality (e.g., odds ratio for the association of COPD with HF: 2.18 [95% confidence interval (CI): 2.08 to 2.26]; hazard ratio for the contribution of HF to mortality in COPD: 1.65 [95% CI: 1.61 to 1.68]). Asthma was independently associated with IHD, and multiple cardiovascular diseases contributed to mortality (e.g., HF hazard ratio: 1.81 [95% CI: 1.75 to 1.87]). ILD was independently associated with IHD and HF, both of which were associated with mortality. Patients with lung disease were less likely to receive coronary revascularization.ConclusionsLung disease is independently associated with cardiovascular diseases, particularly IHD and HF, which contribute significantly to all-cause mortality. However, patients with lung disease are less likely to receive coronary revascularization. |
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Keywords: | asthma chronic obstructive pulmonary disease heart failure interstitial lung fibrosis ischemic heart disease AF atrial fibrillation CABG coronary artery bypass grafting CI confidence interval COPD chronic obstructive pulmonary disease HF heart failure HR hazard ratio ICD-10 International Classification of Disease-10th edition IHD ischemic heart disease ILD interstitial lung disease NHS National Health Service OPCS-4 Office of Population Censuses and Surveys Classification of Interventions and Procedures OR odds ratio PCI percutaneous coronary intervention PVD peripheral vascular disease |
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