{
  "abstract": "Objectives To examine the risk of severe cardiovascular (CV) events in patients with chronic obstructive pulmonary disease (COPD) across different time periods following COPD exacerbations and the incidence rate of cardiopulmonary events in a real-world setting in China.Design Retrospective cohort study.Setting Regional electronic health records database from Yinzhou District of Ningbo City, China.Participants A total of 14 713 patients aged ≥40 years with a first COPD diagnosis between 1 January 2014 and 1 March 2022.Primary and secondary outcome measures The risk of severe CV events (ie, hospitalisation and a primary or secondary discharge code for acute coronary syndrome, heart failure decompensation, cerebral ischaemia, arrhythmia and CV-related death) during different exposed time periods following a COPD exacerbation, the incidence rate of overall cardiopulmonary events (ie, severe exacerbation of COPD, all-cause mortality, inpatient CV events, inpatient ischaemic stroke and inpatient tachyarrhythmia/atrial fibrillation) and the incidence rate stratified by COPD exacerbation history.Results We included a total of 14 713 patients. During a median (IQR) follow-up of 2.8 (4.0) years, 20.1% experienced severe CV events. Compared with the unexposed period, the risk of severe CV events was the highest in the first 10 days following a COPD exacerbation (adjusted HR 10.00, 95% CI 8.16 to 12.25). The risk of severe CV events decreased over time but remained significantly elevated up to 90 days post exacerbation. We found that 32.7% of COPD patients experienced cardiopulmonary events, with a crude incidence rate of 9.38 (95% CI 9.09 to 9.69) per 100 person-years.Conclusion This study is the largest retrospective cohort study investigating CV and cardiopulmonary events among patients with COPD in China. Our findings highlight an elevated risk of CV events closer to the time of COPD exacerbations and show that nearly one-third of COPD patients experience cardiopulmonary events.",
  "authors": [
    {
      "affiliations": [
        "Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China"
      ],
      "name": "Zhike Liu"
    },
    {
      "affiliations": [
        "State Key Laboratory for Innovation and Transformation of Luobing Theory, Department of Cardiology, Jiangsu Province People’s Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, Jiangsu, China"
      ],
      "name": "Iokfai Cheang"
    },
    {
      "affiliations": [
        "Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China"
      ],
      "name": "Yan Chen"
    },
    {
      "affiliations": [
        "Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China"
      ],
      "name": "Meng Zhang"
    },
    {
      "affiliations": [
        "Yinzhou District Centre for Disease Control and Prevention, Ningbo, China"
      ],
      "name": "Peng Shen"
    },
    {
      "affiliations": [
        "Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China"
      ],
      "name": "Wenhao Li"
    },
    {
      "affiliations": [
        "Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital Fudan University, Shanghai, China"
      ],
      "name": "Dongni Hou"
    },
    {
      "affiliations": [
        "Yinzhou District Centre for Disease Control and Prevention, Ningbo, China"
      ],
      "name": "Hongbo Lin"
    },
    {
      "affiliations": [
        "Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China"
      ],
      "name": "Siyan Zhan"
    },
    {
      "affiliations": [
        "Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China"
      ],
      "name": "Feng Sun"
    },
    {
      "affiliations": [
        "Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital Fudan University, Shanghai, China",
        "Shanghai Key Laboratory of Lung Inflammation and Injury, Department of Pulmonary Medicine, Zhongshan Hospital Fudan University, Shanghai, China",
        "Shanghai Respiratory Research Institute, Shanghai, China",
        "National Clinical Research Center for Aging and Medicine, Huashan Hospital Fudan University, Shanghai, China"
      ],
      "name": "Yuanlin Song"
    },
    {
      "affiliations": [
        "State Key Laboratory for Innovation and Transformation of Luobing Theory, Department of Cardiology, Jiangsu Province People’s Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, Jiangsu, China"
      ],
      "name": "Xinli Li"
    }
  ],
  "title": "Risk of severe cardiovascular events and incidence rate of cardiopulmonary events among patients with COPD in China: a retrospective cohort study",
  "uid": "f182a0b0-d535-54b5-8a1d-5932b60aa001"
}