Relation Between COPD Severity and Global Cardiovascular Risk in US Adults
Relation Between COPD Severity and Global Cardiovascular Risk in US Adults
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DOI：
10.1378/chest.11-2421
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发表时间：
2012-11-01
期刊：
影响因子：
9.6
通讯作者：
Wong, Nathan D.
中科院分区：
文献类型：
--
作者：
Lee, Hwa Mu;Lee, Janet;Wong, Nathan D.
背景：COPD与心血管事件(CVE)的风险相关，但其对总死亡率的影响尚未得到很好的量化。我们确定了全球CVE风险评估对慢性阻塞性肺疾病受试者CVE和总死亡率的影响。方法：我们检查了6,266名年龄=40岁的美国成年患者的COPD严重程度与估计的10年CVE风险之间的关系。COPD由肺活量测定定义，严重程度分为轻度(FEV1和FEV1=80%)、中度(50%~50%)、50%(合并中到重度COPD)(P<；0.05)。当全球CVE风险得分较低时，无论COPD严重程度如何，CVE死亡率也很低(10/1000人年)，而当CVE全球风险较高时(>；40/1000人年)，CVE死亡率较高。全球CVE风险评分改善了对COPD患者CVE和总死亡率的预测(P<；.0001)，在肺功能指标之外，重新分类净值分别提高了17.1%(P<；.0001)和13.0%(P<；.0001)。结论：在肺功能数据中加入全球CVE风险评分显著改善了COPD患者对CVE和总死亡率的风险分层，从而增加了对这些患者长期生存的预测。
Background: COPD is associated with the risk of cardiovascular events (CVEs), but its impact on overall mortality has not been well quantified. We determined the impact of global CVE risk assessment on CVE and total mortality in subjects with COPD.Methods: We examined the severity of COPD in 6,266 US adult patients aged >= 40 years in relation to the estimated 10-year risk of CVEs. COPD was defined by spirometry, and severity was classified as mild (FEV1 >= 80%), moderate (50% 50% (with moderate to severe COPD) (P < .05). When global CVE risk scores were low, CVE mortality was also low (< 10/1,000 person-years) regardless of COPD severity, and CVE mortality was high when CVE global risk was high (> 40/1,000 person-years). Global CVE risk improved prediction for both CVEs and total mortality in patients with COPD (P < .0001), with a net reclassification improvement of 17.1% (P < .0001) and 13.0% (P < .0001), respectively, beyond lung function measures.Conclusions: The addition of global CVE risk scores to lung function data significantly improves risk stratification of patients with COPD for CVE and total mortality and, thus, adds to predicting long-term survival of these patients.