Cardiovascular disease in patients requiring NIV for ECOPD

Introduction: Cardiovascular disease (CVD) is a leading cause of early death in patients hospitalised with COPD exacerbations (ECOPD).1 We assessed the burden of CVD and its treatment in a prospective cohort of patients with ECOPD requiring ventilation. Methods: Baseline characteristics, pre-admission medication and inpatient mortality were captured in unique consecutive patients. CVD was defined as Left Ventricular Systolic Dysfunction (LVSD), Atrial Fibrillation (AF), Ischaemic Heart Disease (IHD) or Cor Pulmonale. Comparisons were made by Fishers’ Exact Test. Results: Of 733 patients, 30.8% of patients had a single CVD and 19.2% had two or more. Increasing CVD burden was associated with higher mortality (1 CVD=23.0% vs. 4 CVD=45.5%). In patients with LVSD, mortality was lower in patients on pre-admission ACE inhibitor (ACEi)/Angiotensin Receptor Blocker (ARB). A similar association between IHD and B-Blockers (βb) or statins was not seen. Discussion: CVD in this group is prevalent and mortality is higher with increasing comorbidity. In LVSD lack of ACEi/ARB therapy on admission was associated with higher mortality. Reference: 1. Zvezdin Chest 2009;136:376-380