{
  "abstract": "Background and Importance Asthma is frequently associated with cardiovascular comorbidities, but the specific risk factors predisposing patients with severe asthma to cardiovascular events (CVE) remain poorly defined. Most clinical trials exclude patients with significant comorbidities, limiting applicability to real-world populations. Identifying biomarkers, comorbidities, and treatments linked to cardiovascular risk could guide preventive strategies in severe asthma management.Aim and Objectives To determine clinical risk factors and determinants associated with CVE in patients with severe asthma with a T2 inflammatory phenotype, and to assess whether asthma treatments act as protective or risk markers for these events.Material and Methods We conducted a retrospective cohort study of adults with severe T2 asthma managed at a hospital severe asthma care unit. All patients were receiving biologic therapy and high-dose inhaled corticosteroids (ICS). Additional therapies analysed included oral corticosteroids (OCS), montelukast, and long-acting β2-agonists (LABA). Patients with prior CVE before asthma diagnosis were excluded. Demographics, comorbidities, lung function, biomarkers (blood eosinophils, IgE), and treatments were collected from electronic medical records. CVE considered were myocardial infarction, angina requiring revascularisation, heart failure, supraventricular arrhythmia, stroke, or pulmonary embolism. Statistical analysis was performed using SAS 9.1.Results A total of 164 patients were included (135 women; mean age 57±18 years). Sixteen patients (9.7%) experienced a CVE during follow-up. The most frequent comorbidities were obesity and allergic asthma. Significant associations with CVE were observed for eosinophilic asthma (OR=8.25, 95% CI 3.45–19.74; p<0.001), nasal polyposis (OR=5.17, 95% CI 2.06–12.95; p<0.001), and frequent exacerbations (OR=14.14, 95% CI 4.54–44.14; p<0.001). Higher CVE risk was also found in patients treated with OCS (OR=38.89, 95% CI 13.31–113.63; p<0.001), ICS (OR=32.50, 95% CI 6.70–157.44; p<0.001), montelukast (OR=16.60, 95% CI 6.35–43.38; p<0.001), and LABA (OR=5.65, 95% CI 2.15–14.80; p<0.001). These associations likely reflect disease severity and treatment intensity rather than a direct causal effect of the medications.Conclusion and Relevance In severe T2 asthma, eosinophilic phenotype, nasal polyposis, and frequent exacerbations were strong clinical determinants of CVE. The association of CVE with asthma treatments underscores the importance of considering underlying disease severity when assessing cardiovascular risk in this population.Conflict of Interest No conflict of interest",
  "authors": [
    {
      "affiliations": [
        "Hospital Universitario La Paz, Pharmacy Department, Madrid, Spain"
      ],
      "name": "ME Ibáñez Ronco"
    },
    {
      "affiliations": [
        "Hospital Universitario La Paz, Pharmacy Department, Madrid, Spain"
      ],
      "name": "E Villamañán Bueno"
    },
    {
      "affiliations": [
        "Hospital Universitario La Paz, Pharmacy Department, Madrid, Spain"
      ],
      "name": "L Carrasco Cuesta"
    },
    {
      "affiliations": [
        "Hospital Universitario La Paz, Pharmacy Department, Madrid, Spain"
      ],
      "name": "S Mallón González"
    },
    {
      "affiliations": [
        "Hospital Universitario La Paz, Pharmacy Department, Madrid, Spain"
      ],
      "name": "A Soto Rosa"
    },
    {
      "affiliations": [
        "Hospital Universitario La Paz, Pharmacy Department, Madrid, Spain"
      ],
      "name": "E Villarroya Peiró"
    },
    {
      "affiliations": [
        "Hospital Universitario La Paz, Pharmacy Department, Madrid, Spain"
      ],
      "name": "A Herrero Ambrosio"
    }
  ],
  "title": "4CPS-062 Beyond the airways: identifying predictors of cardiovascular events in severe T2 asthma",
  "uid": "1c3b4237-12c0-5500-aafa-f71ab7ae15e6"
}